Background and aims Regional techniques are preferred when general anesthesia contraindicated or very unsafe in clavicle surgery. Because of the common area of many nerve and the complex innervation of clavicle region, there are different approaches in the selection of regional techniques.

Methods The operated 192 patients for clavicle fracture between 2015–2019 were retrospectively reviewed. All of 168 patients who had adequate anesthesia level with interscalene (ISB) and C4 deep cervical plexus block were listed by age, gender, nationality, ASA classification. Fracture part of clavicle (distal or middle), the effected side of body, the type of trauma (fall-trauma, traffic accident, war injury or seconder operation) and process complications were also noted.

Results The ratio of male was 80.4% and the adult group was 93.5% of patients. Patients in class ASA I-II were 89,9% and 83.9% of patients had primer operation. Patients with midline fracture were 80.2%. Under sedation with ultrasound guidance, mix of 0.25% bupivacaine and 0.5% lidocaine was administered to adult group as 30cc +10cc (ISB + C4) and to geriatric group as 20cc+10cc (ISB + C4). There were not any significant complications.

Conclusions Various peripheral blocks can be preferred when general anesthesia is to be avoided in surgeries on clavicle region because of different and complex innervation. We believe that the combination of ISB and C4 deep cervical plexus block provide sufficient and safe anesthesia, and give advantages such as preservation of spontaneous respiration and hemodynamic stability especially in trauma patients.