Fifty-eight patients undergoing anterior cervical spine surgery were randomized to receive either an ultrasound-guided intermediate cervical plexus (IC) block (n=29) or a cervical erector spinae (ES) block (n=29). The primary outcome was the time to the first request for rescue analgesia (nalbuphine). Secondary outcomes included performance time, onset of sensory block, intraoperative fentanyl use, postoperative pain intensity (VAS scores), total postoperative nalbuphine consumption, and complications (nausea, vomiting, hypotension, and bradycardia). Outcomes were assessed over 24 hours. Overall, the study revealed that although the IC block had shorter performance and sensory onset times, the ES block provided longer-lasting analgesia and required less total nalbuphine. These findings suggest that the ES block may be more effective in reducing postoperative pain medication needs in this patient group.