Comparison of Superficial Cervical Plexus Block Versus Local Infiltration for Pain Relief During Internal Jugular Vein Cannulation
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 9
Abstract
Introduction: Cannulation of internal jugular vein is an indispensable requirement for patients undergoing cardiac surgeries. Generally it is done before induction by giving patients mild sedation and local infiltration of local anaesthetic agent over the neck. In spite of that, patients do complain of discomfort during the procedure which is then accompanied by haemodynamic changes, especially during subcutaneous tunneling and placement of sutures to secure the cannula. The superficial cervical plexus innervates the skin of the jaw, neck and the area close to the clavicle. Keeping this in mind, this study was designed to compare the analgesic effect of the superficial cervical plexus block with local infiltration, and assess the sympathetic response during internal jugular vein cannulation. Material and Methods: An open labelled, prospective, randomized controlled trial was conducted to compare pain relief during internal jugular cannulation after local infiltration with that after superficial cervical plexus block. 200 ASA grade III & IV patients scheduled for various cardiac surgeries were recruited for this study. They were randomly assigned to receive either superficial cervical plexus block (Group I) or local infiltration (Group 2) for analgesia during the cannulation. Patients were monitored for changes in haemodynamic values and evaluated for pain during various stages of the cannulation procedure. Any side effects were also noted. Due to demographic profile of our patients and the ease of use, a simple verbal pain score was used to assess pain. Results: There was statistically no difference in both the groups with respect to demographic profile like age and sex. The pain scores and values of haemodynamic parameters during the procedure of subcutaneous tunneling/dilatation were lower in Group I than in Group II. The difference was statistically significant. No complications were noted in any groups. Conclusion: The study confirmed that superficial cervical plexus block is superior to local infiltration in terms of pain relief during internal jugular vein cannulation in awake patients. Patients in the superficial cervical plexus block group showed more stable haemodynamics throughout the procedure than those in the local infiltration group.
Authors and Affiliations
Harshwardhan A. Tikle, Bhaskar Murlidhar Patil
Keywords
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