Background: To compare the anesthetic efficacy and safety of ultrasound-guided interscalene brachial plexus block (ISBPB) combined with a modified superficial cervical plexus block (SCPB) versus the conventional combination in patients undergoing surgical fixation of proximal humerus fractures. Methods: In this prospective, randomized controlled study, 60 patients undergoing unilateral proximal humerus fracture surgery between January and October 2024 were enrolled. Participants were randomly assigned to either the modified group (receiving ultrasound-guided ISBPB combined with a modified SCPB) or the control group (receiving ultrasound-guided conventional ISBPB combined with a standard SCPB). The onset time of anesthesia, block quality, incidence of diaphragmatic paralysis, Horner syndrome, nerve injury, and patient satisfaction were recorded and compared between groups. Results: There was no statistically significant difference in the overall quality of nerve block between the 2 groups ( P > .05). However, compared to the control group, the modified group showed a slightly prolonged onset time of anesthesia ( P < .05), but a significantly lower incidence of diaphragmatic paralysis, Horner syndrome, and nerve injury (all P < .05). Furthermore, patient satisfaction scores were significantly higher in the modified group ( P < .05). Conclusion: Ultrasound-guided ISBPB combined with a modified SCPB provides effective anesthesia for proximal humerus fracture surgery, while significantly reducing the incidence of block-related complications. This approach may be more favorable for postoperative recovery.
Liu et al. (Fri,) studied this question.