Comparing Local Anesthetic Techniques for Clavicular Surgeries

Ultrasound-guided Selective Supraclavicular Nerve Block with Either Superior Trunk or Clavipectoral Fascial Plane Block for Clavicular Surgery

Surgical fixation for acute clavicular fractures is increasingly preferred among orthopedic surgeons to improve healing and decrease the risk of malunion. Regional anesthesia for clavicular fractures allows rapid recovery, prolonged postoperative analgesia, and less opioid consumption, and so decreases the hospital stay. There is no consensus regarding the best regional anesthetic technique for surgical fixation for acute clavicular fractures. Selective supraclavicular nerve block combined with either superior trunk or clavipectoral fascial plane block is a promising regional anesthetic technique for midshaft clavicular surgeries.

This study will assess if there is a difference in the quality of surgical anesthesia between selective supraclavicular nerve block combined with either superior trunk or clavipectoral fascial plane block for clavicular fractures. Aiming to achieve high-quality surgical anesthesia and postoperative analgesia for middle clavicular fracture surgeries with optimum hemodynamic stability and high patient and surgeon satisfaction.

Inclusion Criteria:

• Age: 18-45 years old.
• Sex: both sexes.
• The American Society of Anesthesiologists (ASA) Physical status: ASA I & II.
• Body mass index (BMI): 18.5 - 24.9 kg/m2.
• Type of operations: surgical repair of the midshaft clavicular injuries.

Exclusion Criteria:

• Patient refusal.
• Known hypersensitivity to lidocaine or bupivacaine.
• Patients with respiratory insufficiency.
• Coagulation disorders or taking drugs affect surgical hemostasis.
• Patients with pre-existing neurological deficits
• Uncooperative patient or with altered mental status.