In Reply We thank Drs Rahman and Mendelsohn for their interest in our recent study. The performance of a neck dissection has been shown to be associated with great and potentially long-lasting pain and is therefore also listed in the German S3 guideline for acute postoperative pain as a surgical procedure with expected high pain levels. Multimodal pain therapy strategies used in various surgical disciplines incorporate the continuous application of local anesthesia in surgical wound cavities. Therefore, this mechanism seems to be reasonable also in the wound cavity after neck dissection. Furthermore, anesthesia of the superficial branches of the cervical plexus also represents an effective technique of anesthesia of the entire lateral neck as it is also performed during local anesthetic procedures on the cervical vessels. Brown has reported that the anterior rami of the second to fourth cervical nerves may also interconnect with peripheral branches of the trigeminal, facial, glossopharyngeal, and hypoglossal nerves. Thus, effective pain relief by a locally applied anesthetic also seems reasonable and effective in the context of neck dissection involving the cervical plexus and, in our opinion, may achieve more than pure anesthesia of the skin of the neck only.
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