Mosaffa Faramarz, Ghasemi Mahshid, Habibi Afsaneh, Minaei Reza, Bazgir Narges, Memary Elham, Shakeri Alireza
Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Akhtar Orthopedic Research Center, Shahid Beheshti Medical University, Tehran, Iran.
Anesth Pain Med. 2024 Jan 20;14(1):e142051. doi: 10.5812/aapm-142051. eCollection 2024 Feb.
Clavicle fractures account for over one-third of shoulder injuries and up to 3.3% of all fractures in adults. While the majority of these fractures can be managed non-surgically, there are instances where surgical intervention is performed. Regional anesthesia (RA) can be a preferred alternative to general anesthesia (GA) to avoid complications and high costs in this surgery. Moreover, the identification of the most optimal approach for RA remains challenging.
This study aimed to compare the efficacy of interscalene block (ISB) with and without superficial cervical plexus block (SCPB) as an anesthetic technique for clavicular fracture operation.
This double-blinded, non-inferiority clinical trial was conducted on 120 patients randomly divided into 2 groups: One receiving ISB and the other receiving ISB with SCPB. The primary outcome was defined as the conversion to GA. Various factors were recorded, including surgery duration, nerve block initiation, analgesics required in the postanesthesia care unit (PACU), and sedation during surgery. Pain was evaluated using the Visual Analog Scale (VAS) in PACU. SPSS version 26 was used for statistical analysis, performing descriptive analysis, Student's -tests, and Mann-Whitney U tests to compare non-parametric variables between the 2 groups. Statistically significant results had a P value of less than 0.05.
A total of 120 patients were randomly divided into 2 equal groups, each consisting of 50 males and 10 females. The mean age of intervention and case groups were 37.23 ± 13.30 and 38.43 ± 11.95 years, respectively. After performing statistical tests (Student's -test and Mann-Whitney U test), there was no significant difference in the initiation time of nerve block, surgery initiation time, surgery duration, the amount of required sedation, VAS scores, and meperidine consumption (P > 0.05). None of the patients in both groups required conversion to GA.
The primary goal was achieved in all included cases, and no patients required conversion to GA. The efficacy of ISB is the same whether or not it is combined with a SCPB. Interscalene block is an alternative RA approach for clavicle fractures. Thus, ISB alone is as efficient as when used in combination with SCPB.
锁骨骨折占肩部损伤的三分之一以上，在成人所有骨折中占比高达3.3%。虽然这些骨折大多数可以采用非手术治疗，但也有需要进行手术干预的情况。区域麻醉（RA）可作为全身麻醉（GA）的首选替代方案，以避免该手术的并发症和高昂费用。此外，确定RA的最佳方法仍然具有挑战性。
本研究旨在比较肌间沟阻滞（ISB）联合或不联合颈浅丛阻滞（SCPB）作为锁骨骨折手术麻醉技术的疗效。
本双盲、非劣效性临床试验对120例患者进行，随机分为2组：一组接受ISB，另一组接受ISB联合SCPB。主要结局定义为转为GA。记录了各种因素，包括手术时间、神经阻滞开始时间、麻醉后护理单元（PACU）所需的镇痛药以及手术期间的镇静情况。在PACU中使用视觉模拟量表（VAS）评估疼痛。使用SPSS 26版进行统计分析，进行描述性分析、Student's -检验和Mann-Whitney U检验，以比较两组之间的非参数变量。具有统计学意义的结果P值小于0.05。
总共120例患者被随机分为2个相等的组，每组由50名男性和10名女性组成。干预组和病例组的平均年龄分别为37.23±13.30岁和38.43±11.95岁。进行统计检验（Student's -检验和Mann-Whitney U检验）后，神经阻滞开始时间、手术开始时间、手术时间、所需镇静量、VAS评分和哌替啶消耗量均无显著差异（P>0.05）。两组患者均无需转为GA。
所有纳入病例均实现了主要目标，且无患者需要转为GA。ISB联合或不联合SCPB的疗效相同。肌间沟阻滞是锁骨骨折的一种替代RA方法。因此，单独使用ISB与联合SCPB使用一样有效。
