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All Journal Jurnal Anestesi Perioperatif Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Purnomo, Heri Dwi
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Education Health Professions Medicine & Pharmacology

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Surface Anatomy-Based Clavipectoral Fascia Plane Block for Clavicle Surgery Purnomo, Heri Dwi; Witjaksana, Risnu
Indonesian Journal of Anesthesiology and Reanimation Vol. 7 No. 1 (2025): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V7I12025.30-34

Abstract

Introduction: Clavicular fractures are often observed cases. In the majority of clavicle fractures, both in adults and children, the fracture is located in the midshaft. Generally, General Anesthesia techniques are usd in such instances, as regional anesthesia through peripheral nerve block often presents its own challenges. The clavipectoral fascial plane block was first introduced in 2017. Apart from its ease of implementation, the Surface Anatomy-Based Clavipectoral Plane Block can avoid the risks associated with other regional anesthesia techniques such as Plexus Brachialis Block or Interscalene Block. Objective: This report aims to provide an overview of the procedures for carrying out surface anatomy-based clavipectoral fascia plane block for clavicle surgery. Case Report: A 33-year-old man with the primary complaint of pain in the right shoulder following a fall while playing football. The patient was diagnosed with closed re-fracture of the clavicle (D) Allman Group I. Clavicle surgery was conducted with the Surface Anatomy-Based Clavipectoral Fascia Plane Block technique. In this patient, local anesthetic agents were administered as Levobupivacaine 0.375% in a volume of 20 cc. The operation lasts approximately 1.5 hours. The Patient’s hemodynamic condition was stable during the surgery. The patient had no complaints and post-operative pain was effectively managed. Conclusion: The surface Anatomy-based Clavipectoral fascia plane block can be considered for clavicular surgery, especially in Allman Group type 1. Besides being easy to implement, this technique also poses fewer risks compared to other regional anesthesia techniques.
Effect of Transversus Abdominis Plane Block with Dexmedetomidine and Clonidine on Numerical Rating Scale and Interleukin–6 Heryadi, Mohamad Ismu; Purnomo, Heri Dwi; Arianto, Ardana Tri
Jurnal Anestesi Perioperatif Vol 14, No 1 (2026)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15851/jap.v14n1.4000

Abstract

Background: The use of adjuvants like dexmedetomidine and clonidine in Tranversus Abdominis Plane (TAP) blocks can enhance analgesic effects. This study aimed to compare the impact of these adjuvants on TAP blocks by measuring postoperative pain using the numerical rating scale (NRS) and interleukin-6 (IL-6) levels.Methods: This study was conducted from January to April 2024 at the Central Surgical Installation of Dr. Moewardi using a double-masked randomized controlled trial design. The study involved 30 patients undergoing cesarean section, divided into two groups: Group A (15 received a TAP block with dexmedetomidine 0.5 mcg/kgBB) and Group B (15 received a TAP block with clonidine 0.5 mcg/kgBB).Results: Independent tests revealed significant differences in NRS and IL-6 levels between the groups (p<0.001), indicating that dexmedetomidine is superior at preventing NRS and IL-6 elevation.Discussion: Conventional epidural opioids effectively manage pain but cause significant side effects and serious risks, including delayed respiratory depression in mothers and adverse effects on breastfed infants, necessitating alternative approaches. TAP block with dexmedetomidine and clonidine adjuvants demonstrated significant effectiveness in reducing postoperative pain, with dexmedetomidine proving superior in prolonging analgesia duration, decreasing rescue medication requirements, and reducing opioid consumption through its anti-inflammatory effects.Conclusion: These findings highlight the positive effects of dexmedetomidine in reducing postoperative inflammation and pain. The results provide grounds for considering dexmedetomidine as an adjuvant in TAP blocks to enhance effective postoperative pain management.
Co-Authors Ardana Tri Arianto Heryadi, Mohamad Ismu Witjaksana, Risnu