Journal of Clinical and Diagnostic Research (Feb 2019)
Efficacy of Combined Interscalene Block and Superficial Cervical Plexus Block for Surgeries of the Clavicle: A Prospective Observational Study
Abstract
Introduction: Although there are regional anaesthetic techniques used to provide analgesia in fractures of clavicle, their routine use as a sole anaesthetic technique for surgical fixation of the same has not been well established. Aim: To assess the clinical efficacy of combined Interscalene Block (ISB) and Superficial Cervical Plexus Block (SCPB) as a sole anaesthetic technique in patients posted for routine clavicular surgeries. Materials and Methods: This was an observational prospective study of adult patients (n=12, 18-65 years of age) posted for routine clavicular studies, who opted for Regional Anaesthesia (RA) over General Anaesthesia (GA). Preoperative Visual Analogue Scale (VAS) scores were recorded for comparison. The regional anaesthetic technique performed was USG-guided combined ISB and SCPB using 30 mL of a local anaesthetic mixture (Bupivacaine 0.5% and lignocaine 1% in 1:1 ratio). Volumes used were 20 mL for ISB and 10 mL for SCPB. The onset of sensory anaesthesia was determined by loss of pain to pin prick along the area of incision to be made at the intervals of 5, 10, 15, 20, 25 and 30 minutes after the block. Intraoperative pain of VAS ≥4 was managed by rescue local anaesthetic infiltration. Perioperatively, patients were assessed for pain and other complications at 30 minutes,1 hour, 2 hours, 4 hours, 6 hours, 8 hours and 24 hours after the block. Results: All patients completed the study successfully under RA. Average duration for onset of anaesthesia was 15.41 minutes. Two patients required additional local anaesthetics of 2-3 mL each intraoperatively. Average duration of analgesia for all patients was 4.54 hours. No unwanted complications were observed. Conclusion: Combined ISB and SCPB as a sole anaesthetic technique is effective for clavicular surgeries.
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