Brachial Plexus Blockage versus General Anesthesia for Upper Extremity Surgery: A Systematic Review and Meta-Analysis

Area of Science:

• Anesthesiology
• Surgical Procedures
• Pain Management

Background:

• Upper limb surgery often involves significant postoperative pain and requires effective anesthesia.
• General anesthesia (GA) and brachial plexus block (BPB) are common anesthetic techniques for these procedures.
• Differences in pain, opioid consumption, and recovery exist between BPB and GA.

Purpose of the Study:

• To compare the efficacy of brachial plexus block (BPB) versus general anesthesia (GA) for upper limb surgery.
• To evaluate differences in rebound pain, opioid consumption, and adverse events.
• To assess the impact on discharge time.

Main Methods:

• A meta-analysis of nine clinical trials involving 487 patients was conducted.
• Data from four databases were systematically searched and analyzed.
• Outcomes measured included pain scores, opioid consumption, adverse events, and discharge time, with statistical analysis using Odds Ratios and Mean Differences.

Main Results:

• Brachial plexus block (BPB) demonstrated significantly lower postoperative pain scores within 2 hours compared to general anesthesia (GA).
• Opioid consumption was reduced in the BPB group within the first 24 hours.
• BPB was associated with fewer postoperative nausea/vomiting events and shorter hospital stays.

Conclusions:

• Brachial plexus block (BPB) provides superior early postoperative pain control and reduced opioid requirements for upper limb surgery.
• BPB is linked to decreased adverse events and expedited discharge compared to GA.
• While pain benefits may decrease after 6 hours due to block wear-off, BPB offers significant perioperative advantages.