The fascial plane blocks in the upper arm surgery and trauma: A narrative review

Fascial plane blocks are becoming popular as useful and safe methods to provide pain relief. While their use in thoracic and abdominal surgery is well known, their application in upper arm surgery and trauma is underscored. This review explores research from the last 10 years focusing the use of fascial plane blocks to relieve pain after surgery or trauma in the upper limb. Studies include randomized controlled trials, observational studies, and case reports. They look at techniques like the cervical and high-thoracic erector spinae plane (ESP) block, the clavipectoral fascia plane (CFP) block, the superior posterior serratus intercostal plane (SPSIP) block, and periarticular approaches like the pericapsular (PENG) shoulder block. The high-thoracic ESP block provided pain relief and was often given with a continuous catheter infusion. The research shows that there is a tendency toward combining fascial blocks with each other or with peripheral nerve blocks to cover more area and cut down on the use of opioids. Even if the results are promising, there aren't many randomized trials in the literature, thus data are still mostly low-quality level. Risk of potential complications, such as local anesthetic systemic toxicity (LAST) or unintentional dissemination to important anatomical areas, exists although not reported. This study shows how fascial plane blocks in upper limb surgery are changing and recommends for more high-quality research to find out when they are best used, how safe they are, and how well they may work.