The application effects of superficial cervical plexus block combined with cervical 5 nerve root block or sternoclavicular fascia plane block in internal fixation of clavicular fractures
LI Peihan
WANG Xuejuan
LI Chengwen
LI Li
Abstract：Objective To compare the application effects of superficial cervical plexus block combined with cervical 5 nerve root block and superficial cervical plexus block combined with sternoclavicular fascia plane block in internal fixation of clavicular fractures.Methods A total of 60 patients with unilateral midclavicular fractures who underwent elective internal fixation of clavicular fractures in Beijing Friendship Hospital,Capital Medical University from March 2021 to December 2023 were recruited.The patients were divided into observation group(receiving superficial cervical plexus block combined with cervical 5 nerve root block)and control group(receiving superficial cervical plexus block combined with sternoclavicular fascia plane block)by using random number table method,with 30 cases in each group.The operation time,intraoperative blood loss,sufentanil and propofol dosages,as well as the effectiveness of nerve block,intraoperative heart rate(HR),mean arterial pressure(MAP)level,postoperative Visual Analogue Scale(VAS)scores,modified Bromage Scale(MBS)scores for upper limb motor function after nerve block,and incidence of complications were compared between the two groups.Results The intraoperative dosages of sufentanil and propofol in the observation group were lower than those in the control group,and the difference was statistically significant(P＜0.05).There were no statistically significant differences between the two groups in terms of the operation time,intraoperative blood loss,and the time of first oral analgesic medication after operation(P＞0.05).The levels of HR and MAP at different time points during operation in the two groups kept stable,and there were no statistically significant differences between the groups(P＞0.05).The effectivenesses of nerve block were good in all the patients.The VAS scores in both groups showed a trend of first decreasing and then increasing at 30 minutes,4 hours,12 hours and 24 hours after operation.At all the time points,the VAS scores in the observation group were significantly lower than those in the control group(P＜0.05).The MBS scores at the state of elbow flexion,wrist flexion,and finger flexion in both groups showed an upward trend at 30 minutes after nerve block and 4 hours,12 hours and 24 hours after operation,and there were no statistically significant differences between the groups(P＞0.05).One case of mild Hornner syndrome and 1 case of partial diaphragmatic paralysis occurred in the observation group after operation,while no complications occurred in the control group.Conclusion Compared with those in superficial cervical plexus block combined with sternoclavicular fascia plane block,the intraoperative dosages of sufentanil and propofol in superficial cervical plexus block combined with cervical 5 nerve root block are lower.However,both anesthesia methods can better preserve the motor function of the affected upper limbs,and the incidence rates of complications such as phrenic nerve block and recurrent laryngeal nerve block are low.
Keywords：Ultrasound-guidedSuperficial cervical plexus blockCervical 5 nerve root blockSterno-clavicular fascia plane blockInternal fixation of clavicular fractures
Publication Date：2024-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1357-1362 )