Ultrasound-guided C3, 4, 5 Nerve Root Block

In the C3, 4, and 5 group, the patients were placed in a position similar to the one described. The probe was placed transversely over the neck to identify the nerve roots from C7 to C4 [15]. Subsequently, the probe was moved slowly to identify the C3 transverse process and nerve root (if possible). Via an in-plane technique, the needle tip was placed posterior to the transverse process or nerve roots. Consequently, 2 mL of 0.5% ropivacaine was slowly injected around the C3 nerve root, and the needle tip was withdrawn subcutaneously. The probe was moved to the C4 level, and 3 mL of 0.5% ropivacaine was injected. After blockade of the C3 and C4 nerve roots was performed, the transverse cutaneous nerve of the neck could be blocked; patients did not feel pain during the C5 nerve root block with 5 mL of 0.5% ropivacaine (Fig. ​(Fig.2D-F).2D-F). To prevent intrathecal injection, the ropivacaine was injected when the needle tip reached the posterior tubercle or was close to the nerve roots. Before the ropivacaine injection, the anesthesiologist performed aspiration to ensure there were no abnormal sensations and there was no cerebrospinal fluid.