Infraclavicular versus costoclavicular approaches to ultrasound-guided brachial plexus block: a systematic review and meta-analysis
Braz. j. anesth
;
74(2): 744465, 2024. tab, graf
Article
Dans Anglais
|
LILACS-Express
| LILACS
| ID: biblio-1557240
ABSTRACT
Abstract Background:
The costoclavicular approach to brachial plexus block may have a more favorable anatomy than the classic infraclavicular approach. However, there are conflicting results in the literature regarding the comparative effectiveness of these two techniques.Methods:
We systematically searched for Randomized Controlled Trials (RCTs) comparing costo-clavicular with infraclavicular brachial plexus blocks for upper extremity surgeries on MEDLINE, EMBASE, and Ovid. The outcomes of interest were sensory and motor block onset times, performance times, block failure, and complication rate. We performed statistical analyses using RevMan 5.4 and assessed heterogeneity using the Cochran Q test and I2 statistics. We appraised the risk of bias according to Cochrane's Risk of Bias 2 tool.Results:
We included 5 RCTs and 374 patients, of whom 189 (50.5%) were randomized to undergo costoclavicular block. We found no statistically significant differences between the two techniques regarding sensory block onset time in minutes (Mean Difference [MD = −0.39 min]; 95% CI −2.46 to 1.68 min; p = 0.71); motor block onset time in minutes (MD = −0.34 min; 95% CI −0.90 to 0.22 min; p = 0.23); performance time in minutes (MD = −0.12 min; 95% CI −0.89 to 0.64 min; p = 0.75); incidence of block failure (RR = 1.59; 95% CI 0.63 to 3.39; p = 0.63); and incidence of complications (RR = 0.60; 95% CI 0.20 to 1.84; p = 0.37).Conclusion:
This meta-analysis suggests that the CCV block may exhibit similar sensory and motor onset times when compared to the classic ICV approach in adults undergoing distal upper extremity surgery, with comparable rates of block failure and complications.
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
langue:
Anglais
Texte intégral:
Braz. j. anesth
Thème du journal:
Anesthésiologie
Année:
2024
Type:
Article
Pays d'affiliation:
Brésil
/
États-Unis d'Amérique
Institution/Pays d'affiliation:
Duke University/US
/
Hospital Regional deAraranguá/BR
/
Universidade Potiguar/BR
/
University of Nebraska Medical Center/US
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