Efficiency and safety of infraclavicular blocks in pediatric supracondylar fractures undergoing closed reduction internal fixation

Efficiency and safety of Infraclavicular Blocks in Pediatric Supracondylar Fractures Undergoing Closed Reduction Internal FixationPeripheral nerve blocks are the most commonly used anesthesia method in adults. Infraclavicular block is a peripheral nerve block that is usually performed with ultrasound guidance while visualizing the subclavian artery under the clavicle. There are insufficient data on peripheral nerve blocks in pediatric cases. In this study, we aimed to report that anesthesia was sufficient with infraclavicular block in children with supracondylar fractures who underwent closed reduction internal fixation while postoperative nausea, vomiting and need for additional opioid were reduced, and that a safe and comfortable surgery was provided. For this study, the records of 70 patients aged 3-16 years who had supracondylar fracture and underwent closed reduction internal fixation surgery were evaluated retrospectively. Patients in Group I received moderate sedation/analgesia according to the ASA sedation/analgesia scale. Demographic data were similar in both groups. 80% success was achieved in patients who were operated with just infraclavicular block. The total success reached 94.3% with 0.05 mcg/kg/min remifentanil infusion administered in the remaining 20% patients, Postoperative additional opioid requirement was significantly lower in patients who applied infraclavicular block compared to those in the general anesthesia receiving group (25.71% in Group G, 5.7% in Group I) (P=0.028). Furthermore, nausea and vomiting were significantly less in patients operated with infraclavicular block (25.71% in Group G and 8.6% in Group I (P=0.072). These results showed that infraclavicular block can be used alone in upper extremity surgery in children while providing effective anesthesia and reliable postoperative analgesia.