Superficial cervical plexus block alone or combined with interscalene brachial plexus block in surgery for clavicle fractures: a randomized clinical trial

Abdelghany, Mohamed; Ahmed, Sameh Abdelkhalik; Afandy, Mohamed Elsayed

doi:10.23736/s0375-9393.21.14865-5

Cited by 20 publications

(19 citation statements)

References 22 publications

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“…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 We excluded one retracted article and its retraction note from the final list of 44 studies [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ,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%

“…Most studies purportedly, in-text, included a SCPB (28 articles). However, considering the nomenclature differences above, we contend that at least 14 of these studies described an ICPB, while 5 studies performed a SCPB ( Table 3 ) [ 7 , 8 , 13 , 15 , 21 , 23 , 25 , 28 , 32 , 33 , 34 , 36 , 37 , 38 , 39 , 42 , 43 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 59 , 60 ]. Taking the in-text description at face value, two articles seemed to describe a deep cervical plexus block with deposition of LA below the prevertebral fascia, while the remaining eight studies did not provide sufficient detail to classify the block [ 8 , 15 , 28 , 33 , 34 , 36 , 37 , 48 , 60 ].…”

Section: Resultsmentioning

confidence: 99%

“…Cervical plexus blockade was also commonly used in combination with another nerve or fascial plane block. The most common combined technique utilized cervical plexus blockade with an ISB, as reported in 18 studies [ 7 , 8 , 13 , 21 , 23 , 25 , 32 , 36 , 37 , 38 , 39 , 43 , 45 , 46 , 48 , 51 , 52 , 53 ]. Of these, five studies utilized a SCPB, and nine studies described an ICPB [ 7 , 13 , 21 , 23 , 25 , 32 , 38 , 39 , 45 , 46 , 48 , 51 , 52 , 53 ].…”

Section: Resultsmentioning

confidence: 99%

“…The most common combined technique utilized cervical plexus blockade with an ISB, as reported in 18 studies [ 7 , 8 , 13 , 21 , 23 , 25 , 32 , 36 , 37 , 38 , 39 , 43 , 45 , 46 , 48 , 51 , 52 , 53 ]. Of these, five studies utilized a SCPB, and nine studies described an ICPB [ 7 , 13 , 21 , 23 , 25 , 32 , 38 , 39 , 45 , 46 , 48 , 51 , 52 , 53 ]. A single case report described a deep cervical plexus block [ 60 ]; however, based on our standardized nomenclature, two other studies had in-text descriptions suggestive of a deep cervical plexus block [ 8 , 51 ].…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2022

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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.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

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

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“…The innervation mainly originates from the cervical plexus and the brachial plexus (5,6). However, the hybrid technique of the superficial cervical plexus block and the interscalene block, which is an effective mode of RA in clavicle and shoulder surgery (7)(8)(9), cannot always provide sufficient surgical anesthesia for the patients undergoing PHF surgery. In previous studies, the branches stem from the upper thoracic nerves (T1-T2, even T3), nearly impossible to be covered by a brachial plexus block, were considered to contribute to the innervation of the upper arm as well (10,11).…”

Section: Introductionmentioning

confidence: 99%

Is It Useful and Necessary to Add a T2 Paravertebral Block to the Regional Anesthesia During Proximal Humeral Fracture Surgery in Elderly Patients? A Prospective and Randomized Controlled Trial

et al. 2022

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ObjectiveThis study was designed to investigate whether it is useful and necessary to add a T2 level thoracic paravertebral block (TPVB) based on brachial-cervical plexus block to avoid incomplete anesthesia in elderly patients undergoing deltopectoral approach proximal humeral fracture (PHF) surgery.Materials and MethodsThis study involved 80 patients scheduled for PHF surgery who were randomized to receive either IC block (combined interscalene brachial plexus with superficial cervical plexus block) or ICTP block (T2 TPVB supplemented with IC block). The primary outcome was the success rate of regional anesthesia. The patient who experienced incomplete block was administered with intravenous remifentanil for rescue, or conversion to general anesthesia (GA) if remifentanil was still ineffective. Secondary outcomes included requirements of rescue anesthesia, sensory block of the surgical region, the incidence of adverse reactions, and block procedure-related complications.ResultsThe success rate of regional anesthesia in the ICTP group was higher compared with the IC group (77.5 vs. 52.5%, p = 0.019). Intravenous remifentanil was required in 32.5% of patients in the IC group and 17.5% in the ICTP group, respectively. Conversion to GA was performed in 15% of patients in the IC group and 5% in the ICTP group. Sensory block at the medial proximal upper arm was achieved in 85% of patients in the ICTP group, whereas 10% in the IC group (p < 0.001). There was no difference between the groups with respect to the incidence of intraoperative adverse reactions. No block-related complications occurred in either group.ConclusionAdding a T2 TPVB is helpful to decrease, but not absolutely avoid the occurrence of incomplete regional anesthesia during PHF surgery in elderly patients. However, considering the potential risks, it is not an ideal option while a minor dose of remifentanil can provide a satisfactory rescue effect.Clinical Trial RegistrationClinicalTrials.gov, identifier: NCT03919422.

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A Big Data Analysis Based Method for Sensor Array Reconstruction of Lidar 3D Images

Lu¹,

Liu²,

Wu³

2023

Lecture Notes in Electrical Engineering

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Superficial cervical plexus block alone or combined with interscalene brachial plexus block in surgery for clavicle fractures: a randomized clinical trial

Cited by 20 publications

References 22 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

Is It Useful and Necessary to Add a T2 Paravertebral Block to the Regional Anesthesia During Proximal Humeral Fracture Surgery in Elderly Patients? A Prospective and Randomized Controlled Trial

A Big Data Analysis Based Method for Sensor Array Reconstruction of Lidar 3D Images

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