Comparison of Single and Double Injection Ultrasound-Guided Supraclavicular Block for Upper Limb Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Q3 Medicine

Asian journal of anesthesiology Pub Date : 2025-03-31 DOI:10.6859/aja.202503_63(1).0002

Rifaldy Nabiel Erisadana, Taufiq Gemawan, Muhamad Rizal Hadi Pratama, Eqiel Navadz Akthar Alami, Achmad Wahib Wahju Winarso, Adelia Handoko

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引用次数: 0

Abstract

Background: The ongoing debate regarding the preferred technique between single-site and double-site injection procedures for supraclavicular block remains unresolved. We conducted this research to evaluate the clinical outcomes of single-site versus double-site injection in patients undergoing upper limb surgery.

Methods: A literature search was conducted up to September 2023 to identify randomized controlled trials (RCTs) comparing the single-site injection group (SG) with the double-site injection group (DG) for the supraclavicular block. The analysis was conducted using Review Manager 5.4, employing either a fixed-effects or random-effects model (PROSPERO; no. CRD42023492703).

Results: Based on the 10 RCTs included in the quantitative analysis, there were no significant differences in success rates (i.e., the primary outcome), surgical anesthesia, total anesthesia-related time, time to first rescue analgesic, and adverse events. However, significant differences were observed in several secondary outcomes. SG showed advantages in terms of shorter performance time (mean difference [MD], -1.02 minutes [95% confidence interval [CI], -1.79 to -0.25; P = 0.01; I^2 = 91%]) and lower blockade pain scores (MD, -0.30 minutes [95% CI, -0.60 to 0.00; P = 0.05; I^2 = 0%]). Conversely, DG demonstrated superiority in terms of faster block onset time (MD, 5.73 minutes [95% CI, 4.91, 6.54; P < 0.00001; I^2 = 1%]), longer duration of the sensory block (MD, -71.77 minutes [95% CI, -139.50 to -4.03; P = 0.04; I^2 = 98%]), and longer duration of the motor block (MD, -33.13 minutes [95% CI, -39.64 to -26.63; P < 0.00001; I^2 = 0%]).

Conclusion: This meta-analysis provides evidence that SG and DG had equivalent success rates. SG revealed favorable outcomes in terms of shorter performance time and lower blockade pain scores. However, DG was considered superior in terms of faster block onset and longer durations of sensory and motor block.

查看原文本刊更多论文

超声引导下单次和双次锁骨上阻滞用于上肢手术的比较：随机对照试验的系统回顾和荟萃分析。

背景：关于锁骨上阻滞的单点注射和双点注射的首选技术的争论仍未解决。我们进行了这项研究，以评估上肢手术患者单部位注射与双部位注射的临床结果。方法：检索截至2023年9月的文献，比较单部位注射组（SG）和双部位注射组（DG）治疗锁骨上阻滞的随机对照试验（rct）。使用Review Manager 5.4进行分析，采用固定效应或随机效应模型(PROSPERO；CRD42023492703)。结果：在纳入定量分析的10项rct中，两组患者在成功率（即主要结局）、手术麻醉、全麻相关时间、首次抢救镇痛时间、不良事件等方面均无显著差异。然而，在几个次要结局中观察到显著差异。SG在较短的表现时间（平均差[MD]， -1.02分钟[95%置信区间[CI]， -1.79至-0.25;P = 0.01; I^2 = 91%]）和较低的封锁疼痛评分（MD, -0.30分钟[95% CI， -0.60至0.00;P = 0.05; I^2 = 0%]）方面显示出优势。相反，DG表现出更快的阻滞发作时间（MD， 5.73分钟[95% CI， 4.91, 6.54; P < 0.00001; I^2 = 1%]），更长的感觉阻滞持续时间（MD, -71.77分钟[95% CI， -139.50至-4.03;P = 0.04; I^2 = 98%]）和更长的运动阻滞持续时间（MD, -33.13分钟[95% CI， -39.64至-26.63;P < 0.00001; I^2 = 0%]）的优势。结论：本荟萃分析提供了SG和DG具有相同成功率的证据。SG在较短的表现时间和较低的封锁疼痛评分方面显示出有利的结果。然而，DG被认为在更快的阻滞发作和更长的感觉和运动阻滞持续时间方面优越。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian journal of anesthesiology Medicine-Medicine (all)

CiteScore

1.00

自引率

0.00%

发文量

期刊介绍： Asian Journal of Anesthesiology (AJA), launched in 1962, is the official and peer-reviewed publication of the Taiwan Society of Anaesthesiologists. It is published quarterly (March/June/September/December) by Airiti and indexed in EMBASE, Medline, Scopus, ScienceDirect, SIIC Data Bases. AJA accepts submissions from around the world. AJA is the premier open access journal in the field of anaesthesia and its related disciplines of critical care and pain in Asia. The number of Chinese anaesthesiologists has reached more than 60,000 and is still growing. The journal aims to disseminate anaesthesiology research and services for the Chinese community and is now the main anaesthesiology journal for Chinese societies located in Taiwan, Mainland China, Hong Kong and Singapore. AJAcaters to clinicians of all relevant specialties and biomedical scientists working in the areas of anesthesia, critical care medicine and pain management, as well as other related fields (pharmacology, pathology molecular biology, etc). AJA''s editorial team is composed of local and regional experts in the field as well as many leading international experts. Article types accepted include review articles, research papers, short communication, correspondence and images.