Cervical Cervicis Plane Block Using Ultrasound Guided in Cervical Spine Surgery for Postoperative Pain Management –A randomized Clinical Study

Cervicis Plane Block in Cervical Spine Surgery

Abstract

Background

Persistent postoperative pain after cervical spine surgery is a common problem in clinical practice even with the advancement of surgical and anesthetic techniques. Our study aims to evaluate the efficacy of 0.25%levobupivacaine with dexmedetomidine versus 0.25% levobupivacaine in cervical cervicis block intra operatively after general anaesthesia and assess the pain postoperatively at 0, 6,12 and 24 hrs.

Material and Methods

This RCT included 66 patients undergoing cervical spine surgery, allocated into Group L (0.25% Levobupivacaine) and Group LD (0.25% Levobupivacaine with 5 mcg Dexmedetomidine). Under general anaesthesia (CCeP) blocks was performed at upper and lower cervical levels using ultrasound guidance, targeting the hyperechoic interfascial plane between the semispinalis cervicis and semispinalis capitis muscles.

Results

Both groups were comparable in baseline demographics (age, gender, ASA, BMI). Hemodynamic and respiratory parameters (HR, SBP, DBP, MAP, SpO₂, EtCO₂) remained stable. Postoperative pain scores (NRS) were consistently lower in Group LD at all time intervals (0, 6, 12, 24 hours), demonstrating superior analgesic efficacy.

Conclusion

In our study, it was observed that in patients undergoing cervical spinal surgery the combination of dexmedetomidine with 0.25% levobupivacaine for an ultrasound guided cervicis-plane block resulted in prolonged duration of post operative analgesia as well as lower and less frequent post-operative pain up to 24 hours without accompanying side effects in terms haemodynamic or respiratory.