Supraclavicular Brachial Plexus Block

CA-2 ·

Case context, local only: Upper extremity surgery, pneumothorax risk, ultrasound-guided technique.
22Sources
6Kept
0Dropped

1 · Find evidence

PubMed query

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22 candidate papers · 4 excluded

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Same-day build

Build finished — 6 points drafted. The deck is in draft and needs your review. Open the draft deck done
PubMed query

Runs the tiered searches, drafts one point per included paper, runs the citation gate and builds a draft deck — the steps below, unattended. Same-day build — drafted locally (medgemma:27b), confirmed against each abstract. The deck still lands in draft: nothing here approves anything.

2 · Teaching points

Source

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6 points

This meta-analysis found that a supraclavicular brachial plexus block reduced the incidence of hemidiaphragmatic paralysis by 46% compared with conventional interscalene blockade in adults undergoing shoulder surgery. PMID 40494113 kept
This randomized controlled trial found that for adults having upper extremity surgery under supraclavicular block, adding perineural dexamethasone to intravenous dexamethasone did not further prolong sensory block duration, indicating intravenous dexamethasone alone is sufficient. PMID 40036049 kept
This randomized controlled non-inferiority trial found that the intertruncal approach to supraclavicular block failed to prove non-inferiority to the classical approach for complete sensory blockade at 20 min, and was associated with inferior musculocutaneous blockade, longer performance time, and higher hemidiaphragmatic paresis incidence. PMID 40740147 kept
This meta-analysis found no significant difference between ultrasound-guided axillary and supraclavicular blocks in adequate surgical anesthesia at 30 minutes, block performance time, or onset time for distal upper limb surgery. PMID 38892896 kept
This meta-analysis of 18 RCTs found that supraclavicular blocks had a lower success rate than infraclavicular blocks (OR 0.61, 95% CI 0.41–0.91) and a higher rate of Horner's syndrome. PMID 39287814 kept
This randomized trial found that administering 0.11 mg/kg of intravenous dexamethasone before supraclavicular brachial plexus blockade for wrist and hand surgery reduced the incidence of rebound pain from 79% to 32% and decreased 24-hour cumulative opioid consumption. PMID 40542311 kept

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