Ultrasound-guided superficial cervical plexus block combined with clavipectoral fascial plane block or interscalene brachial plexus block in clavicle surgery: a single-centre, double-blind, randomized controlled trial.

研究概要

50 patients undergoing elective internal fixation for unilateral clavicle fractures were randomly allotted to be administered with superficial cervical plexus block (SCPB) combined with either clavipectoral fascial plane block (CPB; n=25) or interscalene brachial plexus block (IBP; n=25). The primary outcome of interest was duration of analgesia measured by the time of first use of analgesics. The secondary outcome of interest was the effect of the block, which was measured at 30 min in three areas: sternoclavicular joint, midclavicular and acromioclavicular joint. The additional outcomes of interest were upper limb movement function which was assessed using the Modified Bromage Scale (MBS), pain intensity measured with the visual analog scale (VAS) at 6h, 12h and 24h post-op, diaphragmatic movement before the block and 30 mins after and incidence of complications. The results of the study showed that the duration of analgesia was significantly greater in the CPB group, along with significantly lower VAS pain scores. Block effectiveness post-30 min was observed to be similar in all three areas. The CPB demonstrated significantly better MBS function scores. Significant reductions in diaphragmatic movements were seen in the IBP group along with a 92% incidence of hemidiaphragmatic paresis, while no cases of hemidiaphragmatic paresis was observed in CPB group. 3 cases of Horner’s syndrome was seen in the IBP group.