Articles Tập 67 Số CĐ16 06/11/2026

COMPARISON OF ANESTHETIC EFFICACY BETWEEN SUPERFICIAL CERVICAL PLEXUS BLOCK COMBINED WITH CLAVIPECTORAL PLANE BLOCK OR INTERSCALENE BRACHIAL PLEXUS BLOCK IN MID-SHAFT CLAVICLE SURGERY

Pham Van Thong, Nguyen Duc Lam, Nguyen Thi Thuy Ngan
DOI: 10.52163/yhc.v67iCD16.7007
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Abstract

Objective: To compare surgical anesthesia, upper-limb motor function, diaphragmatic excursion, and adverse events between superficial cervical plexus block combined with clavipectoral plane block (CPB) or interscalene block (ISB).

Methods: This randomized controlled trial included 60 ASA I-II patients undergoing midshaft clavicle fracture fixation, allocated equally to two groups. Outcomes were intraoperative VAS/rescue fentanyl, Modified Bromage Scale (MBS), ultrasound-measured diaphragmatic excursion at 30 minutes, and adverse events. Between-group differences are reported with 95% confidence intervals (CIs)..

Results: Block performance time was 2.31 minutes longer with CPB (95% CI 1.77-2.85). One ISB patient required rescue fentanyl. MBS 3 occurred in 30/30 versus 0/30 patients, a risk difference of 100 percentage points (95% CI 83.9-100). Diaphragmatic excursion at 30 minutes was 1.41 cm greater with CPB (95% CI 0.82-2.00); a reduction of ≥25% occurred in 0/30 versus 12/30 patients. In these 12 patients receiving supplemental oxygen, SpO₂ decreased by 0.42 percentage points (95% CI -0.32 to 1.16). No serious adverse events were recorded..

Conclusion: In ASA I-II patients, both regimens allowed surgery to be completed without conversion of the anesthetic technique. The trial was not designed to establish equivalence or non-inferiority. CPB better preserved upper-limb motor function and diaphragmatic excursion but required more performance time; respiratory safety in patients with limited reserve remains unestablished.

Keywords
Clavipectoral plane block, superficial cervical plexus block, interscalene brachial plexus block, clavicle surgery, diaphragm.
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