Efficacy of superficial cervical plexus block in the management of neck pain due to surgical positioning in patients undergoing burr hole craniotomy for unilateral chronic subdural haematoma under scalp block

This study is designed to assess the effect of superficial cervical plexus block for managing neck pain in patients of unilateral chronic subdural hematoma to be operated under the scalp block. In a case series of Management of Refractory Neck Pain Secondary to Cervicothoracic Myofascial Pain Syndrome patients received TPI with 0.25% levobupivacaine and reported significant relief for 2 weeks. Thereafter, the patient underwent 3 courses of TPI with a mixture of levobupivacaine and depot steroids and reported relief of 30% lasting 4 weeks after each course. Furthermore, the patient underwent a unilateral iCPB  & reported 60% relief at 6-month review.

There is myofacial pain due to prolonged surgical positioning of patients during unilateral burr hole awake craniotomy after giving scalp block .So, we hypothesized that ultrasound guided preoperative superficial cervical plexus block will lead to decreased neck pain & relief the  muscle spasm that occurs  postoperatively in chronic SDH surgery. In the present study neck pain (assessed by NRS scaling) assessed as primary outcome and hemodynamic stability, muscle spasm (assessed by modified Ashworth scale),  dose of rescue analgesic required, patients satisfaction score as secondary outcome during post-op period.