Superficial Cervical Plexus Block for Postoperative Pain Management in Occipital Craniotomies: A Narrative Review

Authors

Shahab Ahmadzadeh, Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA.
Bennett M. Ford, LSU Health Sciences Center - New OrleansFollow
Alex V. Hollander, School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA.
Mary Kathleen Luetkemeier, School of Medicine, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA.
Tomasina Q. Parker-Actlis, Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA.
Sahar Shekoohi, Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA 71103, USA.

Document Type

Article

Publication Date

7-28-2025

Publication Title

Medical sciences (Basel, Switzerland)

Abstract

Post-craniotomy pain is common yet often sub-optimally managed because systemic opioids can obscure postoperative neurologic examinations. The superficial cervical plexus block (SCPB) has, therefore, emerged as a targeted regional anesthesia option for occipital craniotomies. The SCPB targets the C2-C4 nerves to anesthetize the occipital scalp region, covering the lesser occipital nerve territory that lies within typical posterior scalp incisions. Clinical evidence shows the block is effective in reducing acute postoperative pain after occipital craniotomy and diminishes opioid requirements. Studies have demonstrated successful and long-lasting analgesia, reductions in 24-h opioid consumption, and a lower incidence of severe pain. Moreover, the technique exhibits a low complication rate and is safer than a deep cervical plexus block because the injection remains superficial and avoids critical vascular and neural structures. When delivered under ultrasound guidance, major adverse events are exceedingly rare. By reducing opioid use, the SCPB can help reduce postoperative complications, allowing earlier neurological assessments and fewer opioid-related side effects. Incorporation of the SCPB into multimodal analgesia regimens can, therefore, accelerate postoperative recovery by providing regionally focused, opioid-sparing pain control without clinically significant sedation. Overall, current data support the SCPB as a dependable, well-tolerated, and clinically practical approach for managing post-craniotomy pain in patients undergoing occipital approaches. In this narrative review, we will discuss the mechanism of action and anatomy, the clinical application, safety and tolerability, patient outcomes, and emerging future directions of the superficial cervical plexus block and how it mitigates post-occipital craniotomy pain.

PubMed ID

40843722

Volume

13

Issue

3

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Ahmadzadeh, Shahab; Ford, Bennett M.; Hollander, Alex V.; Luetkemeier, Mary Kathleen; Parker-Actlis, Tomasina Q.; and Shekoohi, Sahar, "Superficial Cervical Plexus Block for Postoperative Pain Management in Occipital Craniotomies: A Narrative Review" (2025). School of Medicine Faculty Publications. 3991.
https://digitalscholar.lsuhsc.edu/som_facpubs/3991
10.3390/medsci13030101