Article Text

Download PDFPDF

186 Clavipectoral fascial plane block and supraclavicular nerve block for removal of osteosynthesis material from a clavicle fracture. Why not?
  1. D Gonçalves,
  2. F Teixeira,
  3. C Sousa,
  4. R Graça,
  5. P Miguelez and
  6. C Sampaio
  1. Centro Hospitalar Trás-os-Montes e Alto Douro, Vila Real, Portugal


Background and Aims Clavipectoral Fascial Plane Block (CPB) is most commonly used as an anesthesia and postoperative analgesia technique to clavicle fracture surgery. It consists in a local anesthetic injection under the clavipectoral fascia. The Supraclavicular Nerve from the Superficial Cervical Plexus is responsible for the sensory innervation of the skin that covers the clavicle, shoulder and superior region of the chest, It´s blockage should complement the CPB.

Methods A 25-year-old male patient, ASA I, (weight 70 Kg, height 184cm) who underwent right clavicle fracture surgery under general anesthesia, was now scheduled for osteosynthesis material removal.

After obtaining informed consent to perform surgery under regional anesthesia, we performed an ultrasound-guided supraclavicular nerve block (SCB) and CPB with a total of 25 mL of local anesthetic (12.5 mL Ropivacaine 0,75% and 12.5 mL of Mepivacaine 2%), 5 and 20 ml were administered respectively. The CPB was performed with two needle punctures one at each side of the osteosynthesis material.

Results A satisfactory peripheral nerve block was achieved, and no complications were found. The patient remained calm and hemodynamically stable throughout the entire procedure.

Conclusions The combination of the CPB with the SCB is a safe and easy to perform procedure. It allows risk reduction of phrenic nerve block as well as prevention of upper limb paralysis, when compared to brachial plexus block at the interscalene level. Other benefits are general anesthesia adverse effects avoidance, such as nausea and vomiting, sore throat, as well as airway manipulation.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.