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B89 Clavipectoralis fascia block (CPB) combined with superficial cervical plexus block. Case series for clavicle fracture surgery
  1. A Santos Macias1,
  2. J Nieto Muñoz2,
  3. L Valdes Vilches2,
  4. M Caballero Dominguez2 and
  5. JA Reinaldo Lapuerta2
  1. 1Hospital Costa del Sol, Marbella, Spain
  2. 2Hospital Costa Del Sol, Marbella, Spain


Background and Aims Clavicle fractures have a relatively low incidence. They account for 2–3% of all fractures and around 35% of those of the shoulder girdle. Among the different types of fractures, 80% occur in the middle third of the clavicle. Given the rise of ultrasound-guided peripheral blocks, led by the clavipectoral fascial plane block (CPB), allow more interesting analgesic options than the classic interscalene block.

Methods About 5 cases of clavicle fractures. All the atients were between 28 - 42 years, ASA I except for one patient ASA II due to obesity type I.

All 5 cases were scheduled surgery for open osteosynthesis due to fracture-dislocation of the acromioclavicular joint.

It was performed a balanced general anaesthesia combined with CPB block at mid-clavicular level and superficial cervical plexus block was performed. There were not found any adverse effects or anaesthetic complications. The dose administered was 15 ml of bupivacaine 0.5% for CBP and 5 ml of bupivacaine 0.5% for the superficial cervical plexus block.

Results This block allows anaesthesia of the entire clavicle without blocking the brachial plexus. The clavipectoralis fascia surrounds the clavicle in almost its entirety, and the injection underneath the clavicle is able to block the terminal branches that innervate the clavicle. This offers a valid analgesic alternative, which combined with the blockade of the superficial cervical plexus, provides total analgesic coverage for clavicular surgery.

Conclusions CPB associated with superficial cervical plexus block is an effective analgesic alternative for clavicular surgery, avoiding brachial plexus block.

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