• Michael Shalaby, Orhan Arslan, Oren Mechanic, and Tony Zitek.
• Department of Emergency Medicine and Critical Care, Herbert Wertheim College of Medicine at Florida International University, Advanced Emergency Ultrasound, Mount Sinai Medical Center Miami Beach, 4300 Alton Road, Miami Beach, FL 33140, USA. Electronic address: michael.shalaby@msmc.com.
• Am J Emerg Med. 2023 Sep 1; 71: 697369-73.

IntroductionAcute cholecystitis is a painful inflammatory disease of the gallbladder. The Low Cervical-2 Plane Block is a retrolaminar block that targets the C3, C4, and C5 spinal nerves, which provide sensory innervation to the gallbladder, in order to potentially provide analgesia to patients with pain associated with acute cholecystitis.MethodsIn this brief report, a softly embalmed cadaver was injected with a dye mixture bilaterally.ResultsSubsequent cadaveric dissection revealed spread of the injectate deep to the prevertebral fascia to the C4 lamina on the right side and the C5 lamina on the left side. Also, diffusion of the anesthetic over the ligamenta flava could spread inferiorly and laterally to the spinal nerve roots of C3-C5 and thus potentially target the direct sensory innervation of the gallbladder.ConclusionThe Low Cervical-2 Plane Block is a potentially effective modality for treating intractable pain from acute cholecystitis. However, further cadaveric injections are needed to confirm the exact extent of spread of anesthetic. Clinical application of the Low Cervical-2 Plane Block in patients with acute cholecystitis is needed to establish the efficacy of this theoretical technique.Copyright © 2023 Elsevier Inc. All rights reserved.

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