Department of Emergency Medicine, Highland Hospital - Alameda Health System, Oakland, CA, United States of America.
Department of Emergency Medicine, Highland Hospital - Alameda Health System, Oakland, CA, United States of America.
Am J Emerg Med. 2023 Dec;74:197.e1-197.e3. doi: 10.1016/j.ajem.2023.09.056. Epub 2023 Oct 3.
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. In this case series, we describe the first reported utilization of the CPB for analgesia for acute clavicular fractures in the ED. We performed the CPB for distal and midshaft clavicular fractures on patients who suffered from a variety of traumatic accidents including bicycle accidents, motorcycle accidents, and motor vehicle accidents. All patients experienced significant reductions in their reported pain without any reported complications. Given the need to provide patients with appropriate pain control in the ED, the CPB offers an effective, simple method for providing analgesia without known significant risks, including without the risks associated with high-dose systemic analgesia.
锁骨骨折是急诊科常见的损伤。充分的疼痛控制,包括口服或静脉内药物,是治疗的核心。超声引导锁骨下胸锁筋膜间隙阻滞(CPB),先前在麻醉文献中描述过,可提供锁骨的完全镇痛,且不良反应发生率低。在本病例系列中,我们描述了首次报道的 CPB 在急诊科用于急性锁骨骨折镇痛的应用。我们对因各种创伤事故(包括自行车事故、摩托车事故和机动车事故)导致的锁骨远端和中段骨折的患者实施了 CPB。所有患者的报告疼痛均显著减轻,且无任何报告的并发症。鉴于需要在急诊科为患者提供适当的疼痛控制,CPB 为提供镇痛提供了一种有效、简单的方法,且无已知的重大风险,包括无大剂量全身镇痛相关的风险。