Anesth Pain Med.  2022 Jan;17(1):93-97. 10.17085/apm.21085.

Clavipectoral plane block as a sole anesthetic technique for clavicle surgery - A case report -

• Rosales AL
• Aypa NS

• KMID: 2526533
• DOI: http://doi.org/10.17085/apm.21085

Abstract

Background
The clavipectoral fascial plane block was introduced by Dr. Luis Valdes in a symposium at the 2017 European Society of Regional Anesthesia and Pain Therapy Congress. Case: Clavipectoral plane block (CPB) with intravenous sedation provided surgical anesthesia and analgesia in a 39-year-old male patient with a right midshaft clavicle fracture. This in-plane technique was used to deposit 30 ml of a local anesthesia mixture between the clavipectoral fascia and periosteum on both the medial and lateral sides of the fracture line. Conclusions: Excellent anesthesia and analgesia for up to 16 h post-block were provided by CPB during the clavicle surgery.

Keyword

Analgesia; Anesthesia; Clavicle; Local anesthesia; Nerve block; Ultrasound-guided

Figure

• 

  Fig. 1. (A) Scanning the clavicle medial to the fracture line. (B) Scanning the clavicle lateral to the fracture line. (C) Sonoanatomy of the clavicle and its surrounding structures (dotted lines show the clavipectoral fascia). (D) A schematic illustration showing the surrounding structures of the clavicle and the local anesthesia deposition during the clavipectoral plane block.

• 

  Fig. 2. (A) Needle in-plane at the medial clavicle. (B) Needle in-plane at the lateral clavicle (orange arrows show the needle). The local anesthetic spread (in green color) to the medial (C) and lateral (D) clavicle.

Reference

1. Rivera AS, Lam HY, Macalino JU. Epidemiology of injuries in the Philippines: an analysis of secondary data. Acta Med Philipp. 2018; 52:180–6.

2. Qin M, Zhao S, Guo W, Tang L, Li H, Wang X, et al. Open reduction and plate fixation compared with non-surgical treatment for displaced midshaft clavicle fracture: a meta-analysis of randomized clinical trials. Medicine (Baltimore). 2019; 98:e15638.

3. Shrestha BR, Sharma P. Regional anaesthesia in clavicle surgery. JNMA J Nepal Med Assoc. 2017; 56:265–7.

4. Kukreja P, Davis CJ, MacBeth L, Feinstein J, Kalagara H. Ultrasound-guided clavipectoral fascial plane block for surgery involving the clavicle: a case series. Cureus. 2020; 12:e9072.

5. Fugelli CG, Westlye ET, Ersdal H, Strand K, Bjørshol C. Combined interscalene brachial plexus and superficial cervical plexus nerve block for midshaft clavicle surgery: a case series. AANA J. 2019; 87:374–8.

6. Ince I, Kilicaslan A, Roques V, Elsharkawy H, Valdes L. Ultrasound-guided clavipectoral fascial plane block in a patient undergoing clavicular surgery. J Clin Anesth. 2019; 58:125–7.

7. Sonawane K, Dixit H, Balavenkatasubramanian J, Gurumoorthi P. Uncovering secrets of the beauty bone: a comprehensive review of anatomy and regional anesthesia techniques of clavicle surgeries. Open J Orthop Rheumatol. 2021; 6:019–029.

8. Yoshimura M, Morimoto Y. Use of clavipectoral fascial plane block for clavicle fracture: two case reports. Saudi J Anaesth. 2020; 14:284–5.