A Prospective Comparative Study of Usg Guided Interscalene Block with Superficial Cervical Plexus Block Vs General Anaesthesia for Fixation of Clavicular Fractures

Abstract

Introduction: Clavicular fractures constitute a significant proportion of shoulder girdle injuries, often requiring surgical fixation. While general anaesthesia (GA) has traditionally been the standard approach, ultrasound guided regional anaesthesia techniques such as interscalene brachial plexus block (ISB) combined with superficial cervical plexus block (SCPB) are emerging as effective alternatives, offering potentialbenefits in analgesia, haemodynamic stability, and recovery profile. Materials and Method: This prospective, randomized comparative study was conducted on 60 patients undergoing elective clavicular fracture fixation, randomly allocated into two groups: Group G (n = 30) received GA, and Group B (n = 30) received ultrasound-guided
ISB + SCPB with 20 mL of 0.5% ropivacaine. Baseline characteristics, intraoperative haemodynamics, postoperative pain scores (VAS), opioid requirements, and recovery profiles (Modified Aldrete score)
were assessed. Data were analyzed using SPSS v20.0, with p < 0.05 considered statistically significant.
Results: Group B showed significantly lower postoperative opioid consumption across all time points within 24 hours (p < 0.05) and lower VAS scores at T4 and T8 (median 0 vs 6 and 0 vs 4, p < 0.001).
Intraoperative mean arterial pressure and heart rate remained more stable in Group B, particularly during intubation/incision (p < 0.001). Recovery was faster in Group B, with higher median Aldrete scores at T2 (9 vs 8, p < 0.01). No block-related complications were observed.
Conclusion: Ultrasound-guided ISB + SCPB provides superior postoperative analgesia, better haemodynamic stability, and faster recovery compared to GA for clavicular fracture fixation, making it a safe and effective anaesthetic option in suitable patients.