The following is a summary of “Low CERVICAL-2 plane block, a proposed regional anesthetic technique for acute cholecystitis,” published in the September 2023 issue of Emergency Medicine by Shalaby, et al.

Acute cholecystitis, characterized by gallbladder inflammation and severe pain, poses a clinical challenge. The Low Cervical-2 Plane Block, a novel retrolaminar block, was proposed as a potential analgesic intervention targeting the sensory innervation of the gallbladder by the C3, C4, and C5 spinal nerves.

The brief report described an experiment conducted on a softly embalmed cadaver, where a dye mixture was bilaterally injected to simulate the Low Cervical-2 Plane Block procedure.

Following the cadaveric dissection, the injected dye mixture exhibited significant diffusion, permeating deep beneath the prevertebral fascia. The substance reached the right-side C4 lamina and the left-side C5 lamina. Additionally, it was observed that the anesthetic diffusion extended over the ligamenta flava, potentially reaching and influencing the spinal nerve roots of C3, C4, and C5, which are responsible for the direct sensory innervation of the gallbladder.

The Low Cervical-2 Plane Block showed promise as a potential method for alleviating the intractable pain associated with acute cholecystitis. However, further experiments involving cadaveric injections are essential to determine the extent of anesthetic diffusion precisely. Moreover, clinical application in patients with acute cholecystitis was necessary to validate the practical efficacy of this innovative approach. The findings from the study offered a hopeful avenue for addressing the challenging pain management in acute cholecystitis, potentially providing relief to those affected by this condition.

Source: sciencedirect.com/science/article/abs/pii/S0735675723003042