Bilateral Superficial Cervical Plexus Block to Avoid Airway Manipulation in a Patient With Tracheal Compression and Bleeding Nodular Tracheal Infiltration: A Safe and Feasible Option

This case report describes the successful application of bilateral superficial cervical plexus block (SCPB) to avoid airway manipulation in a patient with tracheal compression and bleeding nodular tracheal infiltration. Our patient was a 65-year-old male with Type 2 diabetes mellitus and systemic hypertension who presented with swelling in the anterior aspect of the right neck, difficulty swallowing, and hemoptysis. Imaging revealed significant tracheal compression and nodular tracheal infiltration that was bleeding on touch. Due to the complex tumor infiltration of the trachea, SCPB was chosen over general anesthesia. The procedure involved unilateral SCPB with intravenous dexmedetomidine initially, followed by SCPB on the other side also to effectively manage change in surgical procedure intraoperatively. This case report emphasizes the potential of SCPB with intravenous dexmedetomidine as an alternative to general anesthesia (GA), especially in patients with difficult airways due to complex tumor infiltration of the trachea.