2024, Vol. 7, Issue 1, Part A

Aim and objectives: To assess the analgesic effectiveness of the US-guided clavipectoral fascia plane block vs US-guided inter scalene brachial plexus block in patients having clavicle surgery.

Materials and methods: Our prospective randomized controlled research involved sixty cases who had clavicle surgery at Tanta University Hospitals' Anesthesia Department for 18 months, from March 2022 to September 2023. Subjects underwent a random and equal categorization to 3 groups, with twenty cases each. Group I got simply the normal analgesic treatment, Group II received a unilateral US-guided CPB block, and Group III received a unilateral US-guided ISB block. All subjects underwent assessment as regards total morphine consumption, NRS, total intraoperative fentanyl consumption, duration till 1^st rescue analgesia, adverse events, and diaphragmatic excursion preoperatively and postoperatively using ultrasound. The primary goal was postoperative morphine usage within the initial twenty-four h following surgical procedure, with secondary outcomes including the Numeric Rating Scale (NRS), duration till 1^st rescue analgesia as well as complications’ occurrence.

Results: A significant variance was documented in total morphine uptake across three groups (p<0.001), with group one consuming more than groups two and III. Group II did not significantly increase morphine intake in comparison with group III. Group III and II had considerably longer wait times for their first analgesic than group I (P2 < 0.001 as well as P1 < 0.001). A significant variance was documented in NRS at rest among the three groups within PACU for two hours, four hours, twelve hours, eighteen hours, as well as twenty-four hours (p<0.05). Nevertheless, no statistically significant change was documented at 6 h (p>0.05). A significant variance was documented in NRS while traveling among all groups at PACU at 2h, 4h, 6h, 12h, 18h, as well as 24h (p<0.05). No statistically significant variance was documented as regards complications’ occurrence among all groups (p>0.05). However, a statistically significant variance was documented among all groups in diaphragmatic hemiparesis (p<0.001).

Conclusion: Preoperative US-guided CPB as well as interscalene brachial plexus block are efficient instruments in analgesia during and after surgery in patients undergoing clavicle surgery because they improve the time to first protect analgesia, reduce postoperative total morphine usage, reduce pain after surgery scores, and improve patient satisfaction.