Impact of supraclavicular versus axillary brachial plexus block on long-term pain, functionality, and return-to-work outcomes in 6692 surgical procedures

锁骨上臂丛神经阻滞与腋路臂丛神经阻滞对6692例手术患者的长期疼痛、功能和重返工作岗位结果的影响

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Abstract

BACKGROUND AND OBJECTIVES: We investigated long-term pain and functionality outcomes following the supraclavicular and axillary brachial plexus block as regard to determine whether there are differences in outcomes following both blocks. DESIGN: Observational study. SETTING: Patients scheduled for elective distal surgery of the upper extremity in 22 private hand surgery centres, between November 2011 and May 2016, were included. PATIENTS: A total of 6692 ASA 1-2 patients, undergoing elective day-case surgery on the upper extremity under either single shot supraclavicular or axillary brachial plexus regional anaesthesia. MAIN OUTCOME MEASURES: Rating-scales on pain and functionality were obtained preoperatively, at day 1, 6 weeks, and at 3 and 12 months postoperatively. In addition, patients time to return to work was obtained. RESULTS: No difference was detected in pain and functionality scores between supraclavicular and axillary block patients from 6 weeks up to 12 months postoperatively, except for less pain following axillary block at day-one and during use at 6 weeks. CONCLUSIONS: The current study reports no superiority of one block over the other in terms of long-term postoperative pain, functionality, and return-to-work outcome. Anaesthetists are therefore free to choose between the supraclavicular and axillary brachial plexus block based on personal preference. TRIAL REGISTRATION: The local research ethics committee approved and registered this study (registration number: MEC-2018-1088).

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