ArticleAnesthesia and pain medicine2025
Comparative effectiveness of bupivacaine and lidocaine-bupivacaine mixtures in brachial plexus block: a systematic review and meta-analysis.
Article in Anesthesia and pain medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Integrated drainage-analgesia in thoracoscopic surgery: cautionary optimism amidst evolving multimodal guidelines.Journal of thoracic disease · 2026Article
- Correcting what cannot be corrected: rethinking publication bias analysis methods in clinical meta-analyses.Korean journal of anesthesiology · 2026Review
- Effects of a Lidocaine-Loaded Alginate/CMC/PEO Electrospun Nanofiber Film on Postoperative Pain and Peritoneal Adhesion in a Rat Model.Medicina (Kaunas, Lithuania) · 2026Article
- Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCombining lidocaine with bupivacaine in brachial plexus blocks seeks to blend rapid onset with extended duration; yet, clinical advantages are uncertain. This systematic review assesses their efficacy against bupivacaine alone in ultrasound-guided brachial plexus blocks.
methodsA systematic search of PubMed, EMBASE, and Cochrane databases was conducted in May 2025. Randomized controlled trials (RCTs) comparing lidocaine-bupivacaine mixtures with bupivacaine alone in ultrasound-guided brachial plexus blocks were included. The primary outcome was sensory block onset time. Secondary outcomes included motor block onset time, sensory and motor block durations, and conversion to general anesthesia. Data were analyzed using a random-effects model, with heterogeneity assessed via I² statistics.
resultsOf 1,490 identified articles, 7 RCTs (358 patients) met the inclusion criteria. No significant difference was found in sensory block onset time (mean difference [MD] -1.81 min, 95% confidence interval [CI] -3.92 to 0.29; P = 0.09; I² = 98%) or motor block onset time (MD 0.02 min, 95% CI -2.34 to 2.39; P = 0.99; I² = 95%) between groups. The mixture reduced sensory (MD -172.88 min, 95% CI -215.18 to -130.59; P<0.00001; I² = 90%) and motor block durations (MD -212.13 min, 95% CI -374.99 to -49.28; P = 0.01; I² = 93%).
conclusionsNo clinical benefit was observed from combining lidocaine with bupivacaine, as there was no improvement in block onset times and a reduction in block durations. Given the very low certainty of evidence, these findings should be interpreted with caution, and further high-quality RCTs are needed.
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