Background: Clavicular fractures are commonly encountered in daily practice, and most cases are operated under general surgery. Until now, there has been a debate about the best approach to manage pain in such cases.

Objectives: We aimed to evaluate whether ultrasound-guided clavipectoral block [clavipectoral fascial plane block (CPB)] would be safe and effective in cases with clavicular fractures.

Methods: This prospective randomized study included a total of 40 patients with clavicular fractures; they were divided into 2 groups. Group 1 included 20 cases who underwent CPB, and group 2 included 20 cases who underwent placebo block. Pain score, duration of analgesia, total analgesic consumption, and procedure-related complications were noted and recorded.

Results: Despite the comparable demographic data between the 2 groups, pain scores were significantly lower in group 1 than in group 2, starting from postanesthesia care unit (PACU) admission until 12 hours after the operation. Group 1 showed a significant reduction in 24-hour opioid consumption and significant prolongation of the duration of analgesia compared to the placebo. Patient satisfaction was significantly better in group 1 than in group 2. No block-related adverse events were recorded.

Conclusions: CPB is a safe and effective regional technique that should be used for pain management after clavicular fixation surgery.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8995874PMC
http://dx.doi.org/10.5812/aapm.121267DOI Listing

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Article Synopsis
  • Brugada syndrome (BS) is a heart condition that leads to abnormal heart rhythms and can result in sudden cardiac death, despite many patients showing no symptoms.
  • A case involving a 40-year-old man with BS required careful anesthetic management during his clavicle surgery, using a combination of general and regional anesthesia.
  • The patient was monitored closely after surgery and was discharged without complications, highlighting the importance of specialized care for patients with BS during medical procedures.
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Ultrasound-guided clavipectoral fascial plane block (CPB) and intermediate cervical plexus block (ICPB) have been used as novel approaches for clavicular fracture surgery in adults. However, there are few reports of ultrasound-guided CPB combined with ICPB for clavicular surgery in children under 18 years of age. A 16-year-old male baseball player (weight, 57 kg; height, 160 cm) was scheduled to undergo open reduction and internal fixation with superior plate placement for a left-sided displaced midshaft clavicular fracture.

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The clavipectoral fascial plane block (CFPB) that has been utilized for clavicle fracture surgeries and pain management is an emerging anesthetic technique. It has been previously used for postoperative pain management, but it can also be used as a stand-alone anesthetic technique for clavicle fracture management. Here we describe a case of a 20-year-old male who underwent open reduction and internal fixation (ORIF) with plating for a mid-shaft clavicular fracture under a CFPB as a sole anesthetic.

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Clavicle fractures are common injuries in the Emergency Department (ED). Adequate pain control with oral or intravenous medications is the central aspect of treatment. The ultrasound-guided clavipectoral plane block (CPB), previously described in anesthesia literature, offers complete analgesia of the clavicle with a low adverse effect profile.

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Letter to the editor.

J Clin Monit Comput

April 2024

Department of Anesthesiology and Perioperative Medicine, Hebei Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Cangzhou, Hebei, China.

We review the study by Xu et al. (J Clin Monit Comput 37(4):985-992, 2023. https://doi.

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