Comparison of ultrasound-guided supraclavicular nerve block combined with clavipectoral fascial plane block versus supraclavicular nerve block along with the upper trunk of brachial plexus "The SCUT block" in clavicle surgery: A single-centre, double-blind, randomised controlled trial.

BACKGROUND AND AIMS

Regional anaesthesia for clavicle surgery focuses on site-specific nerve blocks to minimise the drug volume, prevent unnecessary nerve block, and reduce complications. This study aimed to compare the effectiveness and dynamics of selectively blocking supraclavicular (SC) nerves and upper trunk (UT) of the brachial plexus (SCUT block) with clavipectoral fascial plane (CPF) block as a site-specific regional anaesthesia strategy for clavicle surgery.

METHODS

In this single-centre, double-blinded, randomised study, 50 patients undergoing clavicle surgeries were given either SCUT block or CPF block with SC nerve block under ultrasound guidance with 20 mL of 0.5% ropivacaine. The primary outcome was the total duration of analgesia. The secondary outcomes were onset of sensory blockade, motor impairment, degree of diaphragmatic excursion, visual analogue scale (VAS) score, and patient satisfaction score. Statistical analysis included Student's -test, Chi-square test, and Mann-Whitney U-test as appropriate, with statistical significance set at < 0.05.

RESULTS

The mean duration of postoperative analgesia was 10.34 [standard deviation (SD): 1.20] h in the SCUT group and 8.45 (SD: 0.67) h in the CPF group ( < 0.001) [mean difference: 1.89 (95% CI: 1.15, 1.29)]. The SCUT group exhibited lower VAS scores but higher motor impairment and reduced diaphragmatic excursion than the CPF group. However, the differences in the onset of sensory block and patient satisfaction scores were not statistically significant.

CONCLUSION

The SCUT block and CPF block with SC nerve block are effective site-specific regional anaesthesia strategies for clavicle surgery.