# Effects of Ultrasound-Guided Superficial Cervical Plexus Block With Clavipectoral Fascial Plane Block Versus Superficial Cervical Plexus Block With Interscalene Brachial Plexus Block in Clavicle Surgery: A Prospective Study

## TL;DR

This study compares two regional anesthesia techniques for clavicle surgery, finding that one provides longer pain relief and fewer complications.

## Contribution

The study introduces a safer and more effective regional anesthesia combination for clavicle surgery compared to traditional methods.

## Key findings

- SCPB+CPB provided significantly longer analgesia (14.6 hours) compared to SCPB+ISBPB (10.3 hours).
- SCPB+CPB reduced rescue analgesic use and postoperative pain scores compared to SCPB+ISBPB.
- SCPB+CPB avoided respiratory complications like hemidiaphragmatic paralysis seen in SCPB+ISBPB.

## Abstract

Background

Perioperative pain control in clavicle fixation is challenging due to complex innervation and limitations of conventional anesthesia. Regional techniques provide safer, opioid-sparing alternatives. This study compared the efficacy and safety of superficial cervical plexus block with clavipectoral fascial plane block versus interscalene brachial plexus block in clavicle fixation surgery.

Methodology

In this prospective randomized study, 60 patients scheduled for open reduction and internal fixation of clavicle fractures were allocated into two groups of 30 each. Group 1 received superficial cervical plexus block combined with clavipectoral fascial plane block (SCPB+CPB), while Group 2 received superficial cervical plexus block combined with interscalene brachial plexus block (SCPB+ISBPB). Primary outcomes included duration of analgesia and time to first rescue analgesic requirement. Secondary outcomes were postoperative pain scores, total analgesic consumption, hemodynamic stability, and complications. Data were analyzed using standard statistical tests (chi-square) by SPSS software version 27 (IBM Corp., Armonk, NY, USA). A p-value <0.05 was considered significant.

Results

The SCPB+CPB group demonstrated significantly longer analgesia (14.6 ± 2.1 hours vs. 10.3 ± 1.9 hours, p < 0.001) and delayed rescue analgesic demand (13.8 ± 2.0 hours vs. 9.6 ± 1.8 hours, p < 0.001). Pain scores were consistently lower in Group 1 at all postoperative intervals. Total analgesic consumption within 24 hours was significantly reduced in Group 1. Complications such as hemidiaphragmatic paralysis occurred only in Group 2.

Conclusions

SCPB+CPB provides comparatively better analgesia, reduces rescue analgesic use, and avoids respiratory complications compared to SCPB+ISBPB, establishing it as a safe and effective anesthetic technique for clavicle fixation surgery.