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Background and Aims Shoulder surgeries are among the most painful surgical procedures in orthopedic practice.Interscalene brachial plexus block(ISB), although the most commonly utilized regional anesthesia technique for alleviating pain following shoulder surgery, may result in side effects such as hemidiaphragmatic paresis and Horner’s syndrome.More distal blocks along the brachial plexus may provide postoperative analgesia while potentially having less effect on respiratory functions.The aim of this study was to determine whether there is a difference in postoperative pain scores between ISB and costaclavicular brachial plexus block(CCB).Secondary endpoints were adverse events and postoperative opioid consumption

Methods Our study is a prospective observational study.Following ethical approval, a total of 62 patients undergoing for shoulder surgery under general anesthesia between 01.11.2022 and 01.11.2023 were included in the study after obtaining written informed consent.The local anesthetic agent(20mL of bupivacaine 0.25%) were identical for all study participants.A blinded investigator recorded pain scores at rest at 0.5,1,6,12,18 and 24 hours.Postoperative opioid consumption,time to first analgesic request and adverse effects were statistically compared

Results In both groups,VAS pain scores were similar at 0.5,1,2,3,6,12 and 24 hours(p>0.05).Postoperative opioid consumption was significantly lower in the ISB group compared to the CCB group.There was no significant difference between the time to first analgesic request and the need for rescue analgesia.The number of patients experiencing block-related complications(such as Horner’s syndrome,hoarseness,dyspnea,etc.) was significantly higher in the ISB group compared to the CCB group(25%vs.0%;P<0.05)

Conclusions In patients where preserving lung function is prioritized in relieving pain during shoulder surgery, CCB may useful analgesic alternative to ISB with fewer adverse complications