Randomised clinical trial compares analgesic efficacy of SCPB and CPFB for clavicular surgery, suggesting both are effective.
Introduction: Analgesia during clavicle surgery is complicated due to intricate innervation and percutaneous anatomical placement. Regional anaesthesia methods, such as the Superficial Cervical Plexus Block (SCPB) and the Clavipectoral Fascia Block (CPFB), have proven beneficial, but direct comparative evidence of their analgesic potency is lacking. Aim: To compare the analgesic efficacy of SCPB and CPFB for patients undergoing clavicular surgery. Materials and Methods: A randomised double-blinded clinical study was conducted in the anaesthesiology department of Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India. The study took place from October 2024 to April 2025. A total of 40 American Society of Anesthesiologists (ASA) I-II patients, aged 18-65 years, who underwent clavicle surgery under General Anaesthesia (GA), were included. Under ultrasound supervision, each group of patients—Group A (SCPB) and Group B (CPFB)—received 15 millilitres of 0.25% bupivacaine. The outcome measures were postoperative Visual Analogue Scale (VAS) ratings, time to initial rescue analgesia, the number of analgesic doses in the first 24 hours, haemodynamic parameters and side-effects. Data were entered into an Excel sheet and analysed using Statistical Package for the Social Sciences (SPSS) version 21.0. Results were presented in tabular and graphical forms. An Independent t-test and Chi-square test were used to analyse continuous and categorical variables, respectively. Results: The mean age of patients was comparable between Group A (35.3±6.2 years) and Group B (35.2±6.2 years). The gender distribution and ASA grading were also comparable between the groups, with p-values of 0.74 and 0.75, respectively. There were no notable adverse effects in either group. The time to first rescue analgesia was similar between both groups (Group A: 9.4±5.5 hours vs Group B: 10.3±6.6 hours, p-value =0.664). The total number of rescue analgesic doses required in 24 hours was also similar between the groups, with most patients requiring one or two doses: one dose (Group A: 20% vs Group B: 25%), two doses (Group A: 45% vs Group B: 35%) and three doses (Group A: 35% vs Group B: 40%). Conclusion: This randomised clinical trial found that both SCPB and CPFB offer similar and effective pain control for clavicular surgery. Both blocks provide adequate perioperative analgesia, demonstrating similar pain control and safety profiles. The safety profile of both blocks was favourable, with only mild side-effects, such as nausea and no serious complications. Either block can be effectively used, with the choice guided by clinical judgment and patient needs.
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Bagle et al. (2025) studied this question.
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