{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T03:17:27Z","timestamp":1781925447754,"version":"3.54.5"},"reference-count":16,"publisher":"BMJ","funder":[{"name":"Faculty of Medicine Research Fund, Chiang Mai University, Chiang Mai, Thailand","award":["037-2568"],"award-info":[{"award-number":["037-2568"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2025,7,25]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Ultrasound-guided cervical cervicis plane (CCeP) block has been described to anesthetize the dorsal rami of the cervical spinal nerves for postoperative analgesia in posterior cervical spine surgery. However, the anatomical characteristics and the spread pattern of local anesthetic within the CCeP layer remain inadequately studied. This study utilizes fresh cadaveric models to evaluate the spread of CCeP injections at the C2 and C5 levels, aiming to assess staining of the targeted cervical dorsal rami and to identify any spread to adjacent structures.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Dye injection with 0.1% Methylene Blue was used to perform the CCeP block in 20 fresh frozen cadavers at either C2 or C5 level. The cadavers were dissected to evaluate the extent of dye spread within the CCeP layer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Injections with 10\u2009mL dye at the C2 level resulted in staining of the C2 and C3 dorsal rami consistently. Injections with 10\u2009mL dye at the C5 level resulted in staining of the C3 to C5 dorsal rami consistently, but not above the C2 level of the CCeP layer. No staining of the multifidus muscle, retrolaminar region, or ventral rami was observed with either C2 or C5 injections.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>CCeP block can provide selective blockade of the cervical dorsal rami at multiple vertebral levels. The absence of staining in the multifidus muscle, retrolaminar region, or ventral rami demonstrates the potential for the CCeP block to avoid the risk of associated side effects.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2025-106962","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T02:36:10Z","timestamp":1754966170000},"page":"rapm-2025-106962","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Ultrasound-guided cervical cervicis plane (CCeP) block: a cadaver study"],"prefix":"10.1136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3934-9002","authenticated-orcid":false,"given":"Prangmalee","family":"Leurcharusmee","sequence":"first","affiliation":[{"name":"Anesthesiology, Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siriwat","family":"Thunyacharoen","sequence":"additional","affiliation":[{"name":"Excellence in Osteology Research and Training Center (ORTC), Chiang Mai University, Chiang Mai, Thailand"},{"name":"Department of Anatomy, Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirapat","family":"Inchai","sequence":"additional","affiliation":[{"name":"Excellence in Osteology Research and Training Center (ORTC), Chiang Mai University, Chiang Mai, Thailand"},{"name":"Department of Anatomy, Chiang Mai University, Chiang Mai, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasuk","family":"Mahakkanukrauh","sequence":"additional","affiliation":[{"name":"Anatomy, Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand"},{"name":"Excellence in Osteology Research and Training Center (ORTC), Chiang Mai University Faculty of Medicine, Chiang Mai, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Shabsigh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Westchester Medical Center, Valhalla, New York, USA"},{"name":"Department of Anesthesiology, New York Medical College, Valhalla, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1763-4961","authenticated-orcid":false,"given":"Jeff L","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Westchester Medical Center, Valhalla, New York, USA"},{"name":"Department of Anesthesiology, New York Medical College, Valhalla, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"2025101113165547000_rapm-2025-106962v1.1","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph20032098","article-title":"Ultrasound-Guided Blocks for Spine Surgery: Part 1-Cervix","volume":"20","author":"Adamczyk","year":"2023","journal-title":"Int J Environ Res Public Health"},{"key":"2025101113165547000_rapm-2025-106962v1.2","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2019-101154"},{"key":"2025101113165547000_rapm-2025-106962v1.3","doi-asserted-by":"crossref","unstructured":"Elsharkawy H , Altinpulluk EY . Cervical erector spinae block. In: Akkaya T , C\u00f6mert A , eds. Practical guide for pain interventions: head and neck sonoanatomy. Cham: Springer, 2025. Available: https:\/\/doi.org\/10.1007\/978-3-031-88773-4_10","DOI":"10.1007\/978-3-031-88773-4_10"},{"key":"2025101113165547000_rapm-2025-106962v1.4","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2023-104587"},{"key":"2025101113165547000_rapm-2025-106962v1.5","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2020-101807"},{"key":"2025101113165547000_rapm-2025-106962v1.6","doi-asserted-by":"crossref","unstructured":"Xu JL , Tseng V . Proposal to standardize the nomenclature for paraspinal interfascial plane blocks. Reg Anesth Pain Med 2019. doi:10.1136\/rapm-2019-100696","DOI":"10.1136\/rapm-2019-100696"},{"key":"2025101113165547000_rapm-2025-106962v1.7","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jclinane.2017.06.014","article-title":"Cervical interfascial plane (CIP) block and multifidus cervicis plane (MCP) block: Similarities and tips","volume":"41","author":"Ohgoshi","year":"2017","journal-title":"J Clin Anesth"},{"key":"2025101113165547000_rapm-2025-106962v1.8","doi-asserted-by":"crossref","unstructured":"Rahimi M , Xu JL . Chapter 43. In: Cervical paraspinal interfascial plane block, brown\u2019s atlas of regional anesthesia. Elsevier, 2025: 289\u201394.","DOI":"10.1016\/B978-0-443-11221-8.00043-9"},{"key":"2025101113165547000_rapm-2025-106962v1.9","doi-asserted-by":"crossref","DOI":"10.1097\/AJP.0000000000001269","article-title":"Analgesic Safety and Efficacy of Perioperative Posterior Cervical Muscle Plane Blocks in Elective Posterior Cervical Spine Surgery: A Systematic Review With Meta-analyses","volume":"41","author":"Weisbrod","year":"2025","journal-title":"Clin J Pain"},{"key":"2025101113165547000_rapm-2025-106962v1.10","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.wneu.2022.12.044","article-title":"Ultrasound-Guided Cervical Cervicis Plane Block for Postoperative Pain Control in Cervical Spine Surgery: A Technical Note","volume":"171","author":"Xu","year":"2023","journal-title":"World Neurosurg"},{"key":"2025101113165547000_rapm-2025-106962v1.11","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1002\/ca.22731","article-title":"Magnetic resonance imaging atlas of the cervical spine musculature","volume":"29","author":"Au","year":"2016","journal-title":"Clin Anat"},{"key":"2025101113165547000_rapm-2025-106962v1.12","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1007\/s00540-018-2546-0","article-title":"The tendinous septum of the semispinalis capitis muscle spatially separates the dorsal ramus between C3 and C4","volume":"32","author":"Ohgoshi","year":"2018","journal-title":"J Anesth"},{"key":"2025101113165547000_rapm-2025-106962v1.13","first-page":"101213","article-title":"Analgesic efficacy of inter-semispinal fascial plane block in Patients undergoing Cervical Spine Surgery through Posterior Approach: a randomized controlled trial","volume":"42","author":"Abdelhaleem","year":"2023","journal-title":"Anaesth Crit Care Pain Med"},{"key":"2025101113165547000_rapm-2025-106962v1.14","doi-asserted-by":"crossref","DOI":"10.5812\/aapm-143369","article-title":"Inter-Semispinalis Plane Block Versus General Anesthesia for Postoperative Analgesia in Posterior Cervical Spine Surgery: A Randomized Controlled Trial","volume":"14","author":"Mahmoud","year":"2024","journal-title":"Anesth Pain Med"},{"key":"2025101113165547000_rapm-2025-106962v1.15","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1177\/21925682241254327","article-title":"Efficacy and Safety of Ultrasound Guided Inter-semispinal Plane Block for Postoperative Analgesia in Posterior Cervical Laminectomy - A Prospective Randomised Controlled Study","volume":"15","author":"Ramachandran","year":"2025","journal-title":"Global Spine J"},{"key":"2025101113165547000_rapm-2025-106962v1.16","doi-asserted-by":"crossref","DOI":"10.3390\/healthcare12141426","article-title":"Safety and Preliminary Efficacy of Cervical Paraspinal Interfascial Plane Block for Postoperative Pain after Pediatric Chiari Decompression","volume":"12","author":"Pisapia","year":"2024","journal-title":"Healthcare (Basel)"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2025-106962","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T20:17:07Z","timestamp":1760213827000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2025-106962"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,11]]},"references-count":16,"alternative-id":["10.1136\/rapm-2025-106962"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2025-106962","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,11]]}}}