ReviewSupraclavicular block versus interscalene brachial plexus block for shoulder surgery: A meta-analysis of clinical control trials

- The ultrasound-guided interscalene block and Supraclavicular block were both used in managing pain for shoulder surgery.
- Supraclavicular block could provide e similar analgesic efficacy compared with interscalene block.
- Ultrasound-guided supraclavicular block was associated with a low incidence of hoarseness and Horner syndrome.

BackgroundThe ultrasound-guided interscalene block (ISB) has been considered a standard technique in managing pain after shoulder surgery. However, this method was associated with the incidence of hemi-diaphragmatic paresis. In contrast to ISB, supraclavicular block (SCB) was suggested to provide effective anaesthesia for shoulder surgery with a low rate of side-effects. Thus, we performed a meta-analysis of randomised controlled trials (RCTs) to compare SCB with ISB for evaluating the efficacy and safety.MethodThe literature was searched from PubMed, Wiley Online Library, EMBASE, and the Cochrane Library by two reviewers up to April 2017. All available RCTs written in English that met the criteria were included. Two authors pulled data from relevant articles and assessed the quality with the Cochrane Handbook. Review Manager 5.3 software was used to analyse the data.ResultsFive RCTs and one prospective clinical study met the eligibility criteria and were included in the meta-analysis. We considered that there were no statistically significant differences between supraclavicular and interscalene groups in procedural time (P = 0.81), rescue analgesia (P = 0.53), and dyspnoea (P = 0.6). The incidence of hoarseness and Horner syndrome was statistically lower in the SCB group than in the ISB group (P = 0.0002 and P < 0.00001, respectively).ConclusionThe meta-analysis showed that ultrasound-guided SCB could become a feasible alternative technique to the ISB in shoulder surgery.