Complications associated with three brachial plexus blocking techniques: Systematic review and meta-analysis.

Area of Science:

• Anesthesiology
• Surgical Procedures
• Regional Anesthesia

Background:

• Brachial plexus blocks are common for upper limb anesthesia.
• Three main techniques exist: supraclavicular, infraclavicular, and axillary.
• Complication rates and success rates among these techniques require clarification.

Purpose of the Study:

• To systematically review and compare complication rates and anesthetic success of the three brachial plexus block techniques.
• To identify if any technique offers a lower complication profile or higher success rate.

Main Methods:

• Systematic review and meta-analysis adhering to Cochrane and PRISMA guidelines.
• Inclusion of 25 controlled clinical trials involving 2012 patients.
• Primary outcome: incidence of anesthetic complications; secondary outcomes: anesthetic success, performance time, and latency.

Main Results:

• Vascular puncture was the most frequent complication, followed by transient neurological injury, diaphragmatic paralysis, and pneumothorax.
• No statistically significant differences in complication rates were found among the supraclavicular, infraclavicular, and axillary techniques.
• Anesthetic success rates were also comparable across all three techniques.

Conclusions:

• All three brachial plexus block techniques demonstrate low complication rates with no medium or long-term sequelae.
• No single technique is demonstrably superior in reducing complications.
• Ultrasound guidance is associated with high success rates for all three techniques.