Complicaciones asociadas a tres técnicas de bloqueo del plexo braquial: revisión sistemática y metaanálisis |
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Authors: | FD Casas-Arroyave E Ramírez-Mendoza AF Ocampo-Agudelo |
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Institution: | 1. Hospital Universitario San Vicente Fundación, Departamento de Cirugía, Sección de Anestesiología, Universidad de Antioquia, Medellín, Colombia;2. Hospital Universitario San Vicente Fundación. Sección de Anestesiología, Universidad de Antioquia, Medellín, Colombia;1. Serviço de Anestesiologia, Centro Hospitalar Universitário do Porto, Porto, Portugal;2. Instituto de Ciências Biomédicas Abel Salazar, Universidade do Porto, Porto, Portugal;1. Departamento de Anestesiología y Cuidados Intensivos, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, España;2. Universidad de Basilea, Basilea, Suiza;1. Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital General Universitario de Valencia, Valencia, España;2. Servicio de Microbiología, Hospital General Universitario de Valencia, Valencia, España |
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Abstract: | BackgroundBrachial plexus block has become one of the most widely-used anaesthetic techniques in the world for upper limb anaesthesia. There are three different brachial blocks techniques: supraclavicular, infraclavicular and axillary block. However, its execution is not exempt from possible clinical complications, and it is not clear which of these is associated with a lower complication rate and greater anaesthetic success.Materials and methodsSystematic review and meta-analysis following the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to identify controlled clinical trials reporting the three techniques. The main outcome was the incidence of anaesthetic complications, and the secondary ones were an anaesthetic success, time of performance and anaesthetic latency.Results25 controlled clinical trials, with 2012 patient, were included. The methodological quality of the included studies is moderate to high. For the main outcome, the main complication reported was a vascular puncture, followed by transient neurological injury, symptomatic diaphragmatic paralysis and pneumothorax. No differences were found in complications associated with the three anaesthetic techniques. Additionally, no differences were found regarding anaesthetic success.ConclusionsAnesthetic complications associated with the three brachial block techniques are low, with no medium and long-term sequelae; however, none of the three techniques seems to be superior among them to reduce these complications. All three techniques are highly successful when performed using ultrasound imaging. |
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Keywords: | Brachial plexus block Supraclavicular block Infraclavicular block Axillary block Anaesthetic complications |
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