Arnaut Daniel A, Maltbia Theodis, Sadeghipour Hamed
Anesthesiology and Critical Care, Saint Louis University School of Medicine, Saint Louis, USA.
Anesthesiology and Critical Care, Sisters of St. Mary (SSM) Saint Louis University Hospital, Saint Louis, USA.
Cureus. 2023 Nov 18;15(11):e49027. doi: 10.7759/cureus.49027. eCollection 2023 Nov.
Postoperative pain after surgical clavicle fixation is difficult to treat and often responds incompletely to opioid analgesics. Unfavorable side effects and the risk of misuse of opioid analgesics make regional anesthetic techniques an attractive strategy for treating clavicular pain. Literature on continuous nerve blocks with catheter placement for more prolonged pain control for clavicle fractures is scarce, while such techniques are common for other shoulder surgeries. This case report presents a successful continuous interscalene brachial plexus block (ISB) after surgical fixation of a midshaft clavicle fracture. The patient was discharged home on the day of the operation with a portable pump, which provided a local anesthetic infusion for five days postoperatively. The patient was very satisfied with her pain control and only required one dose of oral opioid analgesic postoperatively.
锁骨手术固定后的术后疼痛难以治疗，对阿片类镇痛药的反应往往不完全。阿片类镇痛药的不良副作用和滥用风险使得区域麻醉技术成为治疗锁骨疼痛的一种有吸引力的策略。关于通过放置导管进行连续神经阻滞以更长期控制锁骨骨折疼痛的文献很少，而这种技术在其他肩部手术中很常见。本病例报告介绍了一例中段锁骨骨折手术固定后成功进行连续肌间沟臂丛神经阻滞（ISB）的病例。患者在手术当天带着便携式泵出院，该泵在术后五天提供局部麻醉剂输注。患者对疼痛控制非常满意，术后仅需一剂口服阿片类镇痛药。
