Ultrasound-Guided Supraclavicular Brachial Plexus Block: A Decade of Advancements in Efficacy, Safety, and Clinical Outcomes – An Updated Systematic Review and Meta-Analysis. | ||
| Egyptian Journal of Anaesthesia | ||
| Volume 41, Issue 1, 2025, Pages 1-13 PDF (1.38 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/egja.2025.386670.1093 | ||
| Authors | ||
| Benny Ponappan1; Hany A. Zaki1; Ahmed Shaban2; Eman E. Shaban3; Amira Shaban4; Nabil Shallik5; Mujeeb UR. Rehman6; Mohammed F. Abosamak* 7 | ||
| 1Emergency Medicine, College of Medicine, Qatar University, Emergency Medicine, Hamad Medical Corporation, Doha, Qatar. | ||
| 2Internal Medicine, Mansoura General Hospital, Faculty of Medicine, Tanta University, Egypt. | ||
| 3Cardiology, Al Jufairi Diagnosis and Treatment, MOH, Qatar | ||
| 4Internal Medicine, Mansoura General Hospital, Egypt. | ||
| 5Department of Clinical Anesthesiology, Anaesthesia, ICU and Perioperative Medicine, Hamad Medical Corporation, Doha, Qatar. | ||
| 6Department of Emergency Medicine, Hamad Medical Corporation, Doha, Qatar. | ||
| 7Department of Anesthesia and Intensive Care Medicine, Faculty of Medicine, Tanta University, Egypt. | ||
| Abstract | ||
| Introduction Ultrasound-guided regional anesthesia has been the go-to choice for most upper limb surgical procedures. Traditionally, anesthetists have preferred the supraclavicular brachial plexus block (SCB) over the infraclavicular approach due to the lower complication rate. In the wake of ultrasound guidance, all these procedures have become less cumbersome. Therefore, this systematic review aimed to critically appraise the evidence on the comparative efficacy and safety of ultrasound-guided SCB (USG-SCB) to other brachial plexus blocks and provide a summary. Methods We carried out a comprehensive literature search on three databases, i.e., Cochrane Central Register for controlled trials (CENTRAL), PubMed, and Science Direct, for all the relevant articles on the use of USG-SCB. Studies were then included in the review according to the inclusion criteria. The Review Manager (RevMan 5.4) was then used in the statistical analysis. Results The comprehensive search found 582 articles, among which 30 met our inclusion criteria for this study. Our statistical synthesis found statistically insignificant block success rates (OR 1.15; 95% CI [0.63, 2.08] p= 0.65) and the procedure time (MD -0.15min; 95% CI [-1.00, 0.70] p= 0.73) between the USG-SCB and the other approaches to brachial plexus block. While overall the incidence of adverse events such as Horner’s syndrome (OR 3.08; 95% CI [0.76, 12.48] p= 0.12) and vascular puncture (OR 0.65; 95% CI [0.27, 1.55] p= 0.34) was not significantly different between USG-SCB and the other approaches combined, a subgroup analysis indicated that the incidence of adverse events was significantly higher in USG-SCB compared to ultrasound-guided infraclavicular brachial plexus block (USG-ICB) and ultrasound guided costoclavicular block (USG-CCB). However, the ultrasound-guided interscalene block (USG-ISB) was associated with a significantly higher incidence of adverse events than the USG-SCB. Conclusions These study findings showed that the USG-SCB has not significantly different efficacy to the other ultrasound-guided brachial plexus blocks. However, it is associated with a higher incidence of adverse events than the other blocks, apart from the USG-ISB. Therefore, the choice of this method of regional anesthesia should be made by considering its advantages and disadvantages. | ||
| Keywords | ||
| Brachial plexus blockade; Ultrasound-guided costoclavicular block; Infraclavicular brachial plexus block; Supraclavicular brachial plexus block; Anesthesia | ||
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