Clavicle fracture surgery under regional anaesthesia: Comparing two different types of peripheral nerve blocks

Abstract

Context: To know the innervation of the structures around the clavicle for clavicle fracture surgery. Aim: To investigate the two different methods of regional anesthesia for internal fixation of clavicle fractures. Methods and Material: 50 cases of clavicle fracture surgery were randomly divided into two groups of 25 patients each. Group 1: Interscalene Brachial plexus block combined with superficial cervical plexus block; Group: II Interscalene Brachial plexus block combined with superficial cervical plexus block and deep C3 and C4 block. All patients were sedated with midazolam-2mg. Onset of analgesia (min), duration of analgesia (hrs) and time of first rescue analgesia (hrs) was recorded. Pain was recorded in VAS scale. Haemodynamic parameters were measured and side effects if any were also recorded. Total analgesic required during the first 6hrs postoperative period was also recorded. Results: In group II onset of analgesia (min) was slightly quicker, though not of much significance, but analgesia was denser, duration of analgesia (hrs) longer and time of first rescue analgesia (hrs) was significantly longer than in Group 1. In Group II use of analgesic drugs or number of cases converted to general anaesthesia was significantly lower than in group 1.Conclusion: Clavicle area of skin and structures around it are innervated by the cervical plexus and brachial plexus of which dominated mainly by the brachial plexus and some cervical plexus involvement. The joint use of deep and superficial cervical plexus block and brachial plexus is the ideal anaesthesia for clavicle fracture surgery.