This study aims to evaluate and compare the efficacy and safety of ultrasound guided superficial cervical plexus block (SCPB) with either clavipectoral fascial plane block (CPB) or interscalene brachial plexus block (ISBP) as an anesthetic technique for clavicle surgeries.
Aged 18 to 65 years.
Both sexes.
American Society of Anesthesiologists (ASA) physical status I, II.
Patients with unilateral clavicular fractures undergo elective internal fixation of clavicle fractures.
Coagulopathy.
Patients with infection at block site.
Allergy to local anesthetics.
Patient with morbid obesity (body mass index >35 kg/m2).
Parallel
Superficial Cervical Plexus Block (SCPB) and Clavipectoral Fascial Plane Block (CPB)
DrugPatients will receive Superficial Cervical Plexus Block (SCPB) and Clavipectoral Fascial Plane Block (CPB).
Superficial Cervical Plexus Block (SCPB) and Interscalene Brachial Block (ISBP)
DrugPatients will receive Superficial Cervical Plexus Block (SCPB) and Interscalene Brachial Block (ISBP)
Success rate
The block will be considered successful when complete sensory block is achieved within 45 min after injection of the study drug and inadequate block will be converted to general anesthesia and excluded from the study.
First request of the rescue analgesia
First request of the rescue analgesia will be recorded from the end of surgery till first dose of morphine administrated
Total morphine consumption
Rescue analgesia of morphine will be given as 2 mg bolus if the visual Analogue Scale (VAS)\> 3 to be repeated after 30 min if pain persists until the VAS \< 4. Each patient will be instructed about postoperative pain assessment with VAS. VAS (0 represents "no pain" while 10 represents "the worst pain imaginable").
Degree of patient satisfaction
The degree of patient satisfaction will be assessed on a 5-point Likert scale patient satisfaction (1, extremely dissatisfied; 2, unsatisfied; 3, neutral; 4, satisfied; 5, extremely satisfied).
Incidence of Complications
Incidence of complications as local anesthetic systemic toxicity, nerve injury, diaphragmatic paresis, pneumothorax and high epidural block.
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