Clavipectoral fascia block with superficial cervical plexus block versus interscalene brachial plexus block with superficial cervical plexus block for postoperative analgesia in clavicle surgeries

Divakar SR, Shivakumar G, Chilla A, Konda RKR

Pdf Page Numbers :- 51-55

Divakar SR^1,*, Shivakumar G¹, Anusha Chilla¹, and Ravi Kumar Reddy Konda¹

¹Department of Anaesthesiology, Mandya Institute of Medical Sciences, Mandya, Karnataka 571401, India

*Corresponding author: Dr. Divakar SR, Department of Anaesthesiology, Mandya Institute of Medical Sciences, Mandya, Karnataka 571401, India. Email: drdivakar83@gmail.com

Received 23 September 2024; Revised 20 November 2024; Accepted 29 November 2024; Published 10 December 2024

Citation: Divakar SR, Shivakumar G, Chilla A, Konda RKR. Clavipectoral fascia block with superficial cervical plexus block versus interscalene brachial plexus block with superficial cervical plexus block for postoperative analgesia in clavicle surgeries. J Med Sci Res. 2025; 13(1):51-55. DOI: http://dx.doi.org/10.17727/JMSR.2024/13-9

Copyright: © 2025 Divakar SR et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: Traditionally, General Anesthesia (GA) has been preferred for clavicle fracture fixation, but recent advancements favor ultrasound-guided regional nerve blocks, offering cost-effectiveness, superior postoperative analgesia, and fewer GA-related adverse effects. The study aimed to compare the duration of post operative analgesia in superficial cervical plexus block with interscalene block (ISB + SCPB) versus superficial cervical plexus block with clavipectoral fascia block (CPB + SCPB) in patients posted for midpoint clavicle surgery.

Material & methods: Prospective observational study was conducted on 70 American Society of Anaesthesiologists (ASA) I and II patients aged between 18 to 60 years of either sex posted for midpoint clavicle surgeries. 35 consecutive patients posted in OT 1 received ISB+SCPB while 35 consecutive patients posted in OT 2 received CPB+SCPB respectively. Patients were monitored for block efficacy in the intraoperative period as well as the duration of postoperative analgesia.

Results: The sensory block onset with ISB+SCPB was 4.9 minutes as compared to 6.5 minutes in CPB+SCPB. Though the sensory onset is delayed in CPB+SCPB, this difference is not statistically significant. ISB+SCPB had the motor block onset at 8.9 minutes and no motor block was elicited in CPB+SCPB. The duration of postoperative analgesia lasted for an average of 12.5 hours in CPB+SCPB as compared to 5.9 hours in ISB+SCPB (p value 0.01).

Conclusion: USG guided CPB+SCPB is a good regional anaesthesia technique which can be considered as an alternative to ISB+SCPB for midpoint clavicle fracture surgery with prolonged post operative analgesia.

Keywords: clavipectoral fascia block, interscalene block, superficial cervical plexus block, midpoint clavicle fractures