The effectiveness of clavipectoral fascia plane block for analgesia after clavicle surgery: a report of five cases

Atalay, Yunus Oktay; Çiftçi, Bahadır; Ekinci, Mine; Yeşiltaş, Serdar

doi:10.23736/s0375-9393.20.14503-6

Cited by 10 publications

(7 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The report by Yoshimura and Morimoto utilized a dual injection CPB plus cervical plexus block for two cases who underwent surgery under GA. The time to first request for analgesia was 13 h to 1 day, highlighting a long duration of postoperative analgesia consistent with that reported by Atalay et al, and by Rosales and Aypa [ 15 , 20 , 28 , 31 ]. Most recently, Zhou et al conducted a RCT comparing ICPB with ISB versus ICPB and CPB in awake patients undergoing midshaft clavicle fracture fixation ( Table 2 and Table 3 ) [ 13 ].…”

Section: Discussionsupporting

confidence: 86%

“…Following a thorough review of the titles, abstracts, full-text, and reference lists, we included and extracted data from a total of 44 studies and/or reports containing patient data, spanning a total of 3161 patients with clavicular fractures who received some form of regional anesthesia and analgesia. We excluded one retracted article and its retraction note from the final list of 44 studies [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. There were 5 RCTs, 5 prospective observational studies, 5 retrospective observational studies, and 29 case reports/case series included in this scoping review ( Figure 1 and Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Atalay et al [ 15 , 31 ] used a single-injection approach for the CPB (20 mL 0.25% bupivacaine). In both studies, patients remained pain-free until 12–24 h postoperatively.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Regional Anesthetic and Analgesic Techniques for Clavicle Fractures and Clavicle Surgeries: Part 1—A Scoping Review

et al. 2022

View full text Add to dashboard Cite

Objective. Clavicle fractures are common injuries potentially associated with significant perioperative pain. However, this region’s complex sensory innervation poses a challenge for regional anesthetic or analgesic (RA) techniques. We conducted this scoping review to summarize the current literature, particularly with regards to motor-sparing techniques. Methods. A scoping review was carried out in accordance with the Joanna Briggs Institute’s framework. All articles describing the use of RA for clavicle fractures or surgery were included. PubMed®, Ovid MEDLINE®, EMBASE®, Scopus®, CINAHL®, and the Cochrane database were searched without language restrictions. Results. Database searches identified 845 articles, 44 of which were included in this review, with a combined patient total of 3161. We included all peer-reviewed publications containing clinical data and summarized the findings. Conclusions. Current evidence of RA techniques in clavicle surgery is heterogeneous, with different approaches used to overcome the overlapping sensory innervation. The literature largely comprises case reports/series, with several randomized controlled trials. Intermediate cervical plexus block is the regional technique of choice for clavicle surgery, and can provide reliable surgical anesthesia when combined with an interscalene block. Cervical plexus block can provide motor-sparing analgesia following clavicle surgery. Promising alternatives include the clavipectoral block, which is a novel motor-sparing regional technique. Further studies are required to determine the efficacy and safety of various techniques.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Regional Anesthetic and Analgesic Techniques for Clavicle Fractures and Clavicle Surgeries: Part 1—A Scoping Review

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Ince et al successfully anesthetized a patient using CPB with skin infiltration and suggested the safe and effective use of CPB to provide anesthesia for clavicle surgeries as an alternative to ISB [ 15 ]. Atalay et al added evidence to support the use of CPB for medial end clavicle fracture to provide anesthesia and analgesia as an alternative to the ISB [ 18 , 26 ]. Kukreja et al further highlighted the motor-sparing and phrenic-sparing effects as added benefits of this more distal block [ 14 ].…”

Section: Case Presentationmentioning

confidence: 99%

Awake Single-Stage Bilateral Clavicle Surgeries Under a Bilateral Clavipectoral Fascial Plane Block: A Case Report and Review of Literature

Sonawane¹,

Dharmapuri²,

Saxena³

et al. 2021

Cureus

View full text Add to dashboard Cite

The clavicle is a frequently fractured bone with an infrequent bilateral occurrence. Regional anesthesia (RA) for clavicle surgeries is always challenging due to its complex innervation arising from the two plexuses (cervical and brachial). Various RA techniques described for clavicle surgeries include plexus blocks, fascial plane blocks, and truncal blocks. Plexus blocks are associated with undesirable effects, such as phrenic nerve blockade and paralysis of the entire upper limb, limiting their application for bilateral regional clavicle surgeries. The clavipectoral fascial plane block (CPB) is a novel, procedure-specific, phrenic-sparing, and motor-sparing RA technique that can provide anesthesia or analgesia for clavicle surgeries. The decision to use the CPB and/or other RA techniques may depend on the site of clavicle injury or variations in clavicular innervation.We report a case of single-stage bilateral clavicle surgery successfully managed with a bilateral CPB alone using ultrasound guidance and landmark guidance separately. The patient was kept awake and comfortable throughout the surgery.In conclusion, CPB can be an effective alternate RA technique in avoiding undesired side effects of more proximal techniques such as phrenic nerve involvement and motor blockade of upper limbs. Landmarkguided CPB can be an alternative with equianalgesic efficacy as of ultrasound-guided CPB in resource-poor or emergency settings.

show abstract

“…Furthermore, the cost of anaesthesia increases the economic burden of patients. Regional anaesthesia can meet the requirements of satisfactory operation, avoid many complications in general and provide good postoperative analgesia [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

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

Cai

et al. 2023

J Clin Monit Comput

View full text Add to dashboard Cite

The sensory innervation of the clavicle is complex, and the best regional block technology for clavicular surgery has yet to be determined. The purpose of this study was to compare the application of ultrasound-guided superficial cervical plexus block combined with clavipectoral fascial plane block verses interscalene brachial plexus block in clavicular surgery. Fifty patients undergoing internal fixation surgery for elective clavicle fractures were randomly divided into two groups (n = 25 for each group): group I and group II. Superficial cervical plexus block combined with clavipectoral fascial plane block was used in group I, and superficial cervical plexus block combined with interscalene brachial plexus block was used in group II. The primary outcome measure was the duration of analgesia. The duration of analgesia in group I was significantly longer than that in group II (P < 0.05). The modified Bromage scale function score in group II was lower than that in group I (P < 0.01). There was no significant difference in the skin acupuncture pain score 30 min after block and visual analog scale (VAS) scores at 6 and 12 h after surgery. However, the 24 h VAS score in group I was lower than that in group II (P < 0.05). The incidence of diaphragmatic paralysis was significantly increased in group II (P < 0.01). Ultrasound-guided superficial cervical plexus block combined with clavipectoral fascial plane block can be used for clavicular surgery. It has a long postoperative analgesia time, can retain the motor function of the involved upper limb and does not cause hemidiaphragmatic paresis.Clinical trial number and registry URL: Clinical Trials.gov; Trial registration number: ChiCTR2000039383; Date of registration: 25 October 2020.

show abstract

The effectiveness of clavipectoral fascia plane block for analgesia after clavicle surgery: a report of five cases

Cited by 10 publications

References 4 publications

Regional Anesthetic and Analgesic Techniques for Clavicle Fractures and Clavicle Surgeries: Part 1—A Scoping Review

Regional Anesthetic and Analgesic Techniques for Clavicle Fractures and Clavicle Surgeries: Part 1—A Scoping Review

Awake Single-Stage Bilateral Clavicle Surgeries Under a Bilateral Clavipectoral Fascial Plane Block: A Case Report and Review of Literature

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

Contact Info

Product

Resources

About