ArticleJournal of anaesthesiology, clinical pharmacology
Effectiveness of supraclavicular nerve and upper trunk of brachial plexus (SCUT) block versus clavipectoral fascia and supraclavicular nerve block (CPFS) in mid-shaft clavicle fracture surgery - A randomized clinical trial.
Article in Journal of anaesthesiology, clinical pharmacology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aims: SCUT blocks the supraclavicular nerve (SCN) and upper brachial plexus trunk, and the clavipectoral fascia block (CPF) blocks the fascia-clavicle nerves. This study compares the SCUT block to the CPFS (CPF block and SCN block), which provides site-specific regional anesthesia (RA) for mid-clavicular surgery. Material and Methods: A prospective, randomized controlled trial with two parallel arms and 1:1 allocation is presented here. 18-60-year-old ASA class 1 or 2 adults scheduled for unilateral mid-shaft clavicular surgery were studied. Group A received SCUT block (4 mL of 2% lidocaine + adrenaline, 4 mL 0.5% bupivacaine, and 2 mL dexamethasone). Group B received CPFS (CPF block and SCN block) with 16 mL of 2% lidocaine + adrenaline, 16 mL of 0.5% bupivacaine, and 2 mL of dexamethasone. Outcomes included block success, partial block success, failure, analgesia duration, and shoulder abduction after block. Results: A total of 30 patients per group were studied. In the SCUT group, block onset time was 5 (2) min, with a 93% success rate, a procedure time of 12 (5) min, and an analgesia duration of 15 (1.75) hours. In comparison, CPFS block onset time was 6 (2) min, success rate was 80%, procedure time was 12 (3) min, and analgesia duration was 6 (2) hours. Shoulder abduction was absent in the SCUT group but present in the CPFS group in all blocked patients. Conclusion: The SCUT and CPFS blocks are effective and site-specific for mid-shaft fracture clavicle surgery. However, the duration of analgesia is longer with the SCUT block requiring a lower drug volume. The CPFS block allows better shoulder movement. Both blocks have similar success rates, onset times, and procedure times.
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