Regional blocks for clavicle fractures: keep Hippocrates in mind

Divella, Michele; Vetrugno, Luigi

doi:10.23736/s0375-9393.21.15630-5

Cited by 2 publications

(2 citation statements)

References 15 publications

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“…With the application of ultrasound, the success rate of blocking is high. Whether the supraclavicular nerve can be successfully blocked is the key to ensuring the anaesthesia effect [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Because of the superficial and anterior location of the clavicle, complete nerve block often requires blocking the clavicle to clinically derive its sensory innervation from the brachial plexus and cervical plexus clinically [ 2 – 8 ]. Effective block of the supraclavicular nerve in the superficial cervical plexus is the key to ensuring effective block in the clavicular region [ 9 , 10 ]. The supraclavicular nerve originates from the midpoint of the posterior edge of the sternocleidomastoid muscle, runs in the superficial cervical fascia, and divides into three branches: internal, middle and external, and distributes throughout the lateral part of the neck, the skin of the upper part of the chest wall and the shoulder [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Single injection technique with ultrasound-guided superficial cervical fascia block combined with brachial plexus block in clavicular surgery: a prospective randomized comparative trial

Zhou,

Wang,

Cheng

et al. 2023

BMC Anesthesiol

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Background To investigate the effects of a single injection technique with ultrasound-guided superficial cervical fascia block combined with brachial plexus block in clavicular surgery. Methods Forty patients, 25 males and 15 females, aged 18–85 years with ASA class I or II underwent unilateral clavicular fracture internal fixation. The patients were randomly divided into a superficial cervical plexus block group (group S, n = 20) and a superficial cervical fascia block group (group F, n = 20). First, the brachial plexus of the intermuscular sulcus of all patients was blocked with an ultrasound-guided injection of one injection with 15ml 0.33% ropivacaine 15ml in both groups. Second, the superficial cervical plexus was blocked by another injection of 5-8ml 0.33% ropivacaine in group S, and the superficial cervical fascia was blocked by an injection with 5-8ml 0.33% ropivacaine in Group F. We evaluated operation time, onset time of anaesthesia, effective time and the grades of nerve block effect in the two groups. Additionally, we evaluated the incidences of local anaesthetic poisoning, hoarseness, dyspnoea, and postoperative nausea and vomiting, and the number of patients requiring remedial analgesia within 24 h. Repeated measurements were analysed by repeated data analysis of variance, and count data were compared by the χ2 test. A P value < 0.05 was considered statistically significant. Results The operation time and onset time in Group F were significantly shorter than those in group S (P < 0.05); the effect of intraoperative block was better than that in group S (P < 0.05), and the effective time was significantly longer in group F than in group S (P < 0.05). However, no severe case of dyspnoea, local anaesthetic poisoning or hoarseness after anaesthesia occurred in either of two groups. There was no significant difference in the rate of postoperative salvage analgesia or that of postoperative nausea and vomiting between the two groups. Conclusions The application of the single injection technique with ultrasound-guided superficial cervical fascia block combined with brachial plexus block in clavicular surgery is beneficial because it shortens the operation time, has a faster onset, produces a more effective block and prolongs the longer analgesia time. Trial registration Chinese Clinical Trial Registry- ChiCTR2200064642(13/10/2022).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%