Comparison of Combined Superficial Cervical Plexus Block (SCPB) And Interscalene Brachial Plexus Block (IBPB) With General Anaesthesia (GA) In Clavicular Surgery In Terms of Outcome In The Immediate Post-Operative Period.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2018, Vol 17, Issue 10
Abstract
Background: General anaesthesia(GA)has the disadvantage of increased neuroendocrine stress, increased usage of drugs, increased postoperative nausea and vomiting (PONV) ,increased sedation and delayed ambulation. Regional anaesthesia(RA) avoids these side effects besides providing superior analgesia and early ambulation in the postoperative period. RA for clavicular surgery has been reserved mainly for analgesia purposes and infrequently used as a sole anaesthetic technique because of its wide nerve supply and consequent difficulty in achieving adequate block. Few case reports showed successful use of combined superficial cervical plexus block and interscalene block as the sole regional anaesthesia technique in clavicular surgeries. But, studies that compares RA with GA for clavicular surgeries in its outcome are lacking. Aims and Objectives: To compare combined superficial cervical plexus and interscalene brachial plexus block with general anaesthesia(GA) in patients for clavicle surgery in terms of :1)Intra operative haemodynamic changes 2)Postoperative analgesia,and 3)Postoperative sedation in the first 24 hours postoperatively. Study Design: Experimental non – randomized clinical trial Methods : Ten patients who opted for RA were compared with ten patients who underwent GA.The RA technique used is combined superficial cervical plexus block and interscalene block .GA was given using conventional method. Intraoperative vitals were recorded using the same parameters in both the groups. Postoperatively, pain scores were evaluated with visual analog scale (VAS) on a horizontal 10 cm scale of 0(no pain) to 10(maximum pain).And sedation scores were evaluated with modified Observer’s Assessment of Alertness/Sedation Scale(OAAS) ranging from 0(no response to noxious stimuli) to 5(responds readily to name spoken in normal tone). Results: The intraoperative blood pressures and heart rates were more stable in the RA group than the GA group. Time for first analgesic demand post surgery was 249 + 84.91 minutes for RA and 30 + 31.55 minutes for GA. The postoperative pain scores for the first 2 hours was significantly lesser in RA than GA. Patients in the GA group have more postoperative complaints and interventions. Patient’s alertness score was also higher in the RA group than the GA group postoperatively. Conclusion: Combined superficial cervical plexus block (SCPB) and interscalene brachial plexus block (IBPB) when compared to general anaesthesia (GA) for clavicular surgeries provides better stability of intraoperative vitals with better outcome in the immediate postoperative period.
Authors and Affiliations
Jonan Puni Kay, Seni Potsangbam, Dishingam Gangmei, Tongbram Yashobanta, Laishram Dhanachandra Singh, Daili Khuo, T. R. Kumaragurubaran
Keywords
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- EP ID EP402379
- DOI 10.9790/0853-1710083340.
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