Ultrasound-guided bilateral superficial cervical plexus block after neck-lift and temporal-lift surgery: Retrospective observational pilot study

Abstract

Background:  Postoperative analgesia after aesthetic neck surgery is poorly characterised, with limited published data on regional analgesic techniques. We report our initial experience with ultrasound-guided bilateral superficial cervical plexus block (SCPB) for neck-lift and temporal-lift procedures.

Methods: In this single-centre retrospective observational case-controlled series, six consecutive patients receiving bilateral SCPB (20 mL of 0.25% bupivacaine at the end of surgery) were compared with 21 contemporaneous controls receiving standard analgesia. All received IV paracetamol and tenoxicam, with on-demand tramadol as rescue. Pain was assessed using the Numeric Rating Scale (NRS, 0–10) at 0, 1, 6, 12, and 24 h, with total analgesic use during hospital stay and satisfaction (1–5 Likert scale) as secondary outcomes. Data are median (IQR); Mann–Whitney U and Fisher exact tests were used.

Results: Groups were balanced for age, sex, BMI, ASA status, and operative duration. NRS scores were lower with SCPB at every time point: 0 vs 3 in PACU and at 1 h (P = 0.0002), 0 vs 2 at 6 h (P = 0.0003), 0 vs 2 at 12 h (P = 0.005), and 0 vs 1 at 24 h (P = 0.016). SCPB patients required fewer total paracetamol vials during their hospital stay (median 2.5 vs 7.0; P = 0.0003) and fewer tenoxicam ampoules (2.0 vs 6.0; P = 0.003). Satisfaction was higher with SCPB (median 5 vs 3; P = 0.0005). No block-related complication occurred.

Conclusion: US-guided bilateral SCPB was associated with lower pain scores, reduced supplemental analgesic use, and higher satisfaction after aesthetic neck surgery. These hypothesis-generating findings should be confirmed in an adequately powered randomised trial.