Bilateral cervical plexus anesthesia in anterior neck surgery

Objective. To evaluate the effectiveness of bilateral cervical plexus block. Material and methods. A two-stage single-center prospective study was conducted. In the first (morphological) stage, 21 blocks were performed on 11 cadavers. We assessed diffusion of anesthetic into anterolateral space of the neck on both sides and involvement of n. vagus, n. phrenicus, tr. sympathicus. Clinical study involved 60 patients who underwent transverse neck incision in the lower third for thyroidectomy, hemithyroidectomy and parathyroidectomy. Patients were divided into two equal groups: group 1 — bilateral cervical plexus block under ultrasound navigation combined with general anesthesia; group 2 — only general anesthesia. Clinical, biochemical and laboratory data were assessed. Results and conclusion. Intermediate cervical plexus blockade under ultrasound navigation using “Articaine-Binergia” solution with adrenaline 20 mg/ml + 0.005 mg/ml from 5 ml to 10 ml is safe and can be performed bilaterally. There are significant advantages of this blockade over general anesthesia.