Efficacy of a Superficial Cervical Plexus Block as an Alternative to General Anesthesia for Mandibular and Perimandibular Surgical Procedures: A Systematic Review

Any oral and maxillofacial surgery often requires reliable anesthesia to ensure analgesia, patient comfort, and surgical efficiency. While general anesthesia is the traditional choice, it carries risks of cardiopulmonary complications, prolonged recovery, and higher resource utilization. A superficial cervical plexus block has emerged as a potential alternative, offering simplicity, safety, and cost-effectiveness. This systematic review aimed to evaluate the efficacy and safety of the superficial cervical plexus block as an alternative to general anesthesia in mandibular and perimandibular, oral, and maxillofacial surgical procedures. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, a comprehensive search of PubMed, Cochrane, Google Scholar, and Wiley (2000-2024) was conducted. Eligible studies included randomized controlled trials, clinical studies, case series, and case reports involving the superficial cervical plexus block in mandibular and perimandibular surgeries. The risk of bias was assessed using the RoB-2 tool and the Joanna Briggs Institute tools for specific types of included studies. Nine studies (n = 164 patients) were included where the superficial cervical plexus block alone or when combined with supplemental local blocks consistently provided effective intraoperative and postoperative analgesia. In comparative trials, superficial cervical plexus block groups demonstrated significantly lower postoperative analgesic requirements and pain scores compared to general anesthesia or local infiltration (p < 0.05). Case series and reports further supported the superficial cervical plexus block's high success rate and patient satisfaction, with negligible complications and rare conversion to general anesthesia. The superficial cervical plexus block is a safe and effective alternative to general anesthesia in selected mandibular and perimandibular surgical procedures, particularly in high-risk or resource-limited settings. Despite heterogeneity and small sample sizes, current evidence supports its wider clinical adoption. Large multicenter randomized controlled trials and standardized protocols are recommended to strengthen the evidence base.