Deep cervical plexus block is a useful adjunct to superficial cervical plexus block for several surgical procedures. This block is often requested by our surgical colleagues for awake carotid endarterectomy surgeries due to the added relaxation of the intrinsic neck muscles and increased density of neck anesthesia, both of which facilitate the performance of the surgery in an awake or sedated patient.

In addition, this block technique could be useful in pain medicine practices when selective nerve root block is requested for evaluation of cervical spine disease. Besides avoiding the need for fluoroscopic guidance, the safety profile of this approach to the cervical nerve roots is theoretically superior.

The deep cervical plexus block involves blockade of the ventral rami of the C2-4 nerve roots. The landmark for needle placement is the anterior tubercle of the transverse processes of these vertebrae. Needle placement deep to the prevertebral fascia is the key...

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