Efficacy of Interscalene brachial plexus block for surgical repair of clavicle fracture

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Created On: 10/05/2020

Efficacy of Interscalene brachial plexus block for surgical repair of clavicle fracture

This was a matched case-control cohort study, intended to assess the analgesic efficacy of ultrasound guided interscalene brachial plexus block (US-ISB) in patients to undergo an open reduction and internal fixation (ORIF) of middle or lateral clavicle fracture.

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Key take away

Derived from this study, patients who were given ultrasound guided interscalene brachial plexus block required less intraoperative Sufentanil, consumed less opioid equivalents post-surgically.

Background

Method

In this study, fifty consecutive patients reserved for surgical fixation of middle/lateral clavicle fracture were registered. General anaesthesia with ISB was administered in these patients. They were compared to a historical control of seventy-six retrospective patients without regional block. The primary outcome was post-surgical consumption of overall i.v. morphine equivalent. Each ISB-treated patient was matched to the patient without ISB and their differences were evaluated. Matching used a 1-to-1, nearest-neighbour method via the Mahalanobis metric.

Result

The patients under consideration with ISB displayed considerably lower i.v. morphine equivalent consumption at 2 postoperative hours (0.7 mg) as compared to the controls 8.8 mg.

Conclusion

ISB found to provide pain relief following the surgical fixation of middle and lateral clavicle fracture. The study outcomes can help surgeons a better analgesic strategy for this type of surgery. Further studies are needed to recognise the optimal regional technique for medial third clavicle fractures and the clinically significant contributions of the cervical and brachial plexus.