Discussion
critically ill, hemidiaphragmatic, Pain, fracture, pain, fractures
ADVERSE REACTIONS, CRITICALLY ILL
In 2017, Valdés first proposed the regional anaesthesia technique CPB at the 36th European Society of Regional Anesthesia & Pain Therapy (ESRA) Symposium. Under the guidance of ultrasound, 10–15 mL of local anaesthesia was injected between the clavipectoral fascia and the superior aspect of the clavicle. Several case studies have confirmed that CPB can be used for anaesthesia and postoperative analgesia in clavicular surgery [In this study, the primary observation outcome was the time of first use of analgesics. The results of our study show that the first analgesic use in group I was 20 ± 5.8 h, which was significantly longer than that in group II, indicating that SCPB combined with CPB has longer analgesia. Leurcharusmee [There was no significant difference in the effect scores in the sternoclavicular joint, midclavicle and acromioclavicular joint between the two groups 30 min after the block. The results show that the effects of the two kinds of regional anaesthesia are very good, and our results were consistent with the results of Ince [Although SCPB combined with ISBP can provide sufficient analgesia in clavicle surgery, it can lead to serious adverse reactions, such as hemidiaphragmatic paresis[This study has several limitations. First, clavicle fractures are divided into proximal, middle and distal fractures according to the fracture site and are nondisplaced, displaced and comminuted. In this study, the effects of different fracture sites and fracture types were ignored. Second, since clavicle fractures are often common in young and middle adults, most of the cases included were nonelderly patients with good physical function. Therefore, its clinical application in elderly or critically ill patients is worthy of further exploration. Third, this study found that most patients prefer not to stay awake during surgery. They believed that even if they did not feel pain during the operation, they still felt anxious and afraid. Therefore, we suggest that some sedative drugs, such as dexmedetomidine, should be introduced into clinical practice to increase the comfort of patients.