A comparative evaluation of landmark versus modified technique of superficial cervical plexus nerve block in the maxillofacial surgical practice.

Abstract

Purpose: This study aims to compare two techniques for administering superficial cervical plexus block (SCPB) in maxillofacial surgery: the landmark technique and the modified technique proposed by Hadzic. The research explores whether the modified technique improves precision, accelerates anesthetic onset, and enhances patient outcomes.

Methods: A prospective, single-blinded, randomized clinical study was conducted on 35 patients undergoing maxillofacial surgical procedures at the Goa Dental College and Hospital. Patients were divided into two groups: Group A received SCPB using the landmark technique, and Group B received the modified technique. Both groups underwent additional inferior alveolar and buccal nerve blocks. Key variables measured included time to anesthetic onset, pain levels using the visual analogue scale (VAS), patient comfort, and intraoperative anesthetic requirements. Data were analyzed using SPSS version 22, employing the Mann-Whitney U test and Wilcoxon signed-rank test.

Results: The modified technique demonstrated a significantly shorter mean onset time of anesthesia (4.66 ± 1.27 min) compared to the landmark method (11.72 ± 3.78 min; p < 0.001). Postoperative pain scores after 10 min were significantly lower in the modified group (p < 0.001). Both groups reported high patient comfort, with minimal complications observed.

Conclusion: In conclusion, the superficial cervical plexus block is safe and effective for oral and maxillofacial surgeries, providing good anesthesia for the jaw and neck. While generally sufficient, deeper anesthesia may be required for some procedures. Combined with a mandibular nerve block, it offers a reliable alternative to general anesthesia. However, a larger, more diverse sample is needed to evaluate its efficacy across procedures.

Clinical trial number: Not applicable.