The Clavicle Chronicles: Combined Interscalene Targeting C5, C6 and Intermediate Cervical Plexus Block for Clavicle Surgery. A Case Series

Document Type : Case report

Authors

1 Department of anaesthesiology, Topiwala National Medical College, Nair Hospital, Mumbai. India

2 Department of Anaesthesiology, Topiwala National Medical College

Abstract

Introduction: Due to the complex innervation of the clavicle, sole regional anesthesia (RA) for clavicle fractures surgeries was considered difficult or incomplete and had limitations. This case series demonstrates the efficacy of combined interscalene targeting C5, C6 and intermediate cervical plexus block under dual guidance as the exclusive anaesthetic technique for the patients undergoing surgical repair of clavicle fracture.
Cases: We report the successful anaesthetic management of 15 patients posted for clavicle surgery under RA. Patients were given ultrasound and peripheral nerve stimulator guided interscalene block targeting C5 and C6 with 8-10ml and intermediate cervical plexus block with 5ml of 1% lignocaine +0.25% bupivacaine. We observed effective surgical anaesthesia for open reduction, internal fixation and plating of clavicle, no complications and postoperative analgesia up to 12 hours.
Conclusions: Combined interscalene targeting C5 and C6 and intermediate cervical plexus block using dual guidance, low concentration local anaesthetic solution was effective and safe for clavicle surgery. It provided optimum, site- specific surgical anaesthesia, without any complications, preserving the motor function of the upper limb, ensured adequate postoperative analgesia, contributing to enhanced patient recovery.

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