Original ArticlesDeep Cervical Plexus Block for Neck and Shoulder Pain Due to Myofascial Pain A Randomized Clinical TrialNaja, Ahmad S. MD*; Madi, Naji MD†; Tfayli, Yehia MD*; Ziade, Fouad PhD‡; Haber, Georges MD§; Kanawati, Saleh MD∥; Naja, Zoher MD, PhD∥Author Information *Orthopedic Division, American University of Beirut Medical Center ‡Faculty of Public Health, Lebanese University ∥Anesthesia and Pain Management Department, Makassed General Hospital, Beirut §Orthopedic Division, Mount Lebanon Hospital, Hazmiyeh, Lebanon †Orthopedic Department, Duke University Medical Center, Durham, NC The authors declare no conflict of interest. Reprints: Zoher Naja, MD, PhD, Anesthesia and Pain Management Department, Makassed General Hospital, PO Box 11-6301, Riad EI-Solh, Beirut 11072210, Lebanon (e-mail: [email protected]). The Clinical Journal of Pain: February 2021 - Volume 37 - Issue 2 - p 133-139 doi: 10.1097/AJP.0000000000000904 Buy Metrics Abstract Objectives: Myofascial pain is one of the most common causes of regional pain with no definitive treatment. This randomized clinical trial was conducted to assess the efficacy of deep cervical plexus block versus placebo injection (sham block) for the treatment of myofascial neck and shoulder pain in terms of analgesic consumption and pain during a follow-up period of 2 weeks after the block. Materials and Methods: Patients were randomly divided into 2 groups. Group I (block) received deep cervical plexus block and group II (placebo) received normal saline. A total of 66 patients were included in the study, 34 patients in the block group and 32 patients in the placebo group. Results: Two weeks after the intervention, the average pain duration was significantly lower in the block group: 1.38±1.39 versus 5.25±1.72 for the block and placebo groups, respectively (P<0.0001). Pain intensity was significantly less in the block group such that 2.9% of patients in the block group had severe pain compared with 53.1% of patients in the placebo group (P<0.0001). Two weeks after receiving the block, the mean opioid consumption calculated as tramadol equivalent was 21.1±44.2 mg compared with 166.1±118.8 mg for the block and placebo groups, respectively. Multivariate analysis showed that patients with a longer history of pain had a higher pain score after 2 weeks. The possibility of recovery is affected by pain duration as patients with a history of chronic pain were least affected by the block. Discussion: This technique could be an alternative to pharmacological and other nonpharmacological treatments for myofascial pain. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.