Ultrasound Guided Superficial Cervical Plexus and Superior Trunk Interscalene Block as Sole Anaesthetic Technique for Acromioclavicular Joint Fixation Surgery

Paul, Anju Annie; Ranjan, RV; George, Sagiev Koshy; Suranigi, Shishir Murugharaj

doi:10.7860/jcdr/2019/41029.12792

Cited by 5 publications

(13 citation statements)

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“…The combination of ultrasound-guided interscalene and SCP block has been successfully used for open reduction and internal fixation of clavicle fracture [12]. Also, ultrasound-guided SCP and superior trunk interscalene blocks have been used as sole anesthetic techniques for acromioclavicular joint fixation surgery [13].…”

Section: Discussionmentioning

confidence: 99%

“…Analgesia for Clavicular Surgery/Fractures. Symposia 01: Postoperative Analgesia for Orthopedic Upper and Lower Limb Surgery: Symposium conducted at the 36th Annual European Society of Regional Anaesthesia and Pain Therapy (ESRA) Congress, Lugano, Switzerland; September [13][14][15][16] Since this initial report, a handful of additional case reports have been published that support the efficacy of this block for clavicular surgery [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound-Guided Clavipectoral Fascial Plane Block for Surgery Involving the Clavicle: A Case Series

Kukreja

Davis

MacBeth

et al. 2020

Cureus

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The clavipectoral fascial plane block (CPB) is a novel regional anesthesia technique that has been utilized for clavicular fracture surgery. While the cutaneous innervation of the skin above the clavicle is well-known to be supplied by the supraclavicular nerve of the superficial cervical plexus (SCP), the sensory innervation of the clavicle itself is somewhat controversial. Despite this controversy, it has been hypothesized that the CPB is an effective regional anesthesia technique for peri-operative analgesia since the terminal branches of many of the sensory nerves like suprascapular, subclavian, lateral pectoral, and long thoracic nerves pass through the plane between the clavipectoral fascia and the clavicle itself.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ultrasound-Guided Clavipectoral Fascial Plane Block for Surgery Involving the Clavicle: A Case Series

Kukreja

Davis

MacBeth

et al. 2020

Cureus

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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%

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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“…Although the high-volume ISB often blocks the cervical plexus [35], combinations of RA techniques are recommended to avoid complications. Such combinations include ultrasound-guided ISB + SCPB [36], superior trunk block + SCPB [37], or SCUT (selective supraclavicular + upper trunk) block [38]. Sivashanmugam et al considered the SCUT block as an effective site-specific RA strategy for clavicle surgery in their study on 70 patients [38].…”

Section: Discussionmentioning

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

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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.

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Ultrasound Guided Superficial Cervical Plexus and Superior Trunk Interscalene Block as Sole Anaesthetic Technique for Acromioclavicular Joint Fixation Surgery

Cited by 5 publications

References 0 publications

Ultrasound-Guided Clavipectoral Fascial Plane Block for Surgery Involving the Clavicle: A Case Series

Ultrasound-Guided Clavipectoral Fascial Plane Block for Surgery Involving the Clavicle: A Case Series

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

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