A Combination of Interscalen Brachial Plexus Block and Superficial Cervical Plexus Block in The Patient to be Operated on for Clavicular Excision of Chordoma: A Case Report
Article Sidebar
Main Article Content
Abstract
Background: Clavicular surgery can be performed under general or regional anesthesia with peripheral nerve blocks.
Case: A 29-year-old man with cerebrovascular disease, interstitial lung disease, tumour in lung, right vocal cord paralysis, cervical, thoracic and lumbar stabilization was scheduled for regional anesthesia to undergo metastatic chordoma at clavicle. Considering the risks, the patient who will be operated on for tumour excision in the right clavicle, who is predicted to have difficult intubation due to limitation of extension secondary to a previous posterior cervical instrumentation, is treated with interscalene brachial plexus block and superficial cervical plexus block combination to avoid multiple drug use and complications that may arise during intubation.
Conclusions: Regional anesthesia seems like a reasonable alternative to general anesthesia and may be a good option for perioperative analgesia management in clavicle surgery.
Article Details
Copyright (c) 2025 Polat E, et al.
This work is licensed under a Creative Commons Attribution 4.0 International License.
1. McMaster ML, Goldstein AM, Bromley CM, Ishibe N, Parry DM. Chordoma: incidence and survival patterns in the United States, 1973–1995. Cancer Causes Control. 2001;12:1–11. Available from: https://doi.org/10.1023/a:1008947301735
2. McCain MA. Chordoma in a chronic pain patient. Arch Phys Med Rehabil. 1985;66(7):457–8. Available from: https://pubmed.ncbi.nlm.nih.gov/3160321/
3. Catton C, O'Sullivan B, Bell R, Laperriere N, Cummings B, Fornasier V, et al. Chordoma: long-term follow-up after radical photon irradiation. Radiother Oncol. 1996;41(1):67–72. Available from: https://doi.org/10.1016/s0167-8140(96)91805-8
4. Feigl GC, Litz RJ, Marhofer P. Anatomy of the brachial plexus and its implications for daily clinical practice: regional anesthesia is applied anatomy. Reg Anesth Pain Med. 2020;45(8):620–7. Available from: https://doi.org/10.1136/rapm-2020-101435
5. Aunac S, Carlier M, Singelyn F, De Kock M. The analgesic efficacy of bilateral combined superficial and deep cervical plexus block administered before thyroid surgery under general anesthesia. Anesth Analg. 2002;95(3):746–50. Available from: https://doi.org/10.1097/00000539-200209000-00039
6. Pandit JJ, Satya-Krishna R, Gration P. Superficial or deep cervical plexus block for carotid endarterectomy: a systematic review of complications. Br J Anaesth. 2007;99(2):159–69. Available from: https://doi.org/10.1093/bja/aem160
7. Baran O, Kır B, Ateş İ, Şahin A, Üztürk A. Combined supraclavicular and superficial cervical plexus block for clavicle surgery. Korean J Anesthesiol. 2020;73(1):67–70. Available from: https://doi.org/10.4097/kja.d.18.00296
8. Fugelli CG, Westlye ET, Ersdal MD, Strand KD, Bjørshol C. Combined interscalene brachial plexus and superficial cervical plexus nerve block for midshaft clavicle surgery: a case series. AANA J. 2019;87(5):374–8. Available from: https://pubmed.ncbi.nlm.nih.gov/31612842/
9. Shams D, Sachse K, Statzer N, Gupta RK. Regional anesthesia complications and contraindications. Clin Sports Med. 2022;41(2):329–43. Available from: https://doi.org/10.1016/j.csm.2021.11.006
10. Marhofer P, Greher M, Kapral S. Ultrasound guidance in regional anaesthesia. Br J Anaesth. 2005;94(1):7–17. Available from: https://doi.org/10.1093/bja/aei002
11. Herring AA, Stone MB, Frenkel O, Chipman A, Nagdev AD. The ultrasound-guided superficial cervical plexus block for anesthesia and analgesia in emergency care settings. Am J Emerg Med. 2012;30(7):1263–7. Available from: https://doi.org/10.1016/j.ajem.2011.06.023
12. Reverdy F. Combined interscalene-superficial cervical plexus block for clavicle surgery: an easy technique to avoid general anesthesia. Br J Anaesth. 2015;115:eLetters Supplement. Available from: https://doi.org/10.1093/bja/el_12970
13. Ryan DJ, Iofin N, Furgiuele D, Johnson J, Egol K. Regional anesthesia for clavicle fracture surgery is safe and effective. J Shoulder Elbow Surg. 2021;30(7):e356–60. Available from: https://doi.org/10.1016/j.jse.2020.10.009