Efficacy and Safety of Retroclavicular Brachial Plexus Block for Pain Management after Shoulder Surgeries: a Narrative Review.

purpose of reviewPostoperative pain following shoulder surgeries, including rotator cuff repair and arthroplasty, can be severe and impede early mobilization, prolong recovery, and increase opioid consumption. Regional anesthesia has emerged as a cornerstone of multimodal pain management for these procedures, offering targeted analgesia with fewer systemic side effects. Among the various techniques, the retroclavicular approach to the brachial plexus, known as the retroclavicular brachial plexus block (RCB) or retroclavicular approach to the infraclavicular brachial plexus (RAPTIR), has gained attention for its promising efficacy and safety profile. This narrative review evaluates current evidence surrounding the retroclavicular block's clinical utility in postoperative shoulder pain control. We examine anatomical and technical considerations, analgesic efficacy, safety, and comparative advantages over traditional approaches such as the interscalene and supraclavicular blocks. RECENT

findingsLiterature suggests that RCB provides effective pain relief with reduced risk of phrenic nerve involvement and diaphragmatic paralysis, a critical advantage in patients with respiratory compromise. Additionally, its favorable ergonomic profile and improved needle visibility under ultrasound make it an appealing alternative in elective and emergent settings. The present investigation explores RCB's integration into multimodal analgesia protocols and applicability in obese and geriatric patients, highlighting current research's limitations. Although data remains limited, emerging evidence supports the retroclavicular block as a safe and effective option for shoulder analgesia, warranting further comparative studies and broader clinical adoption.