Evidence map›Paper›PMID 41428588›Full record

SynthesisEuropean surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes2026

Brachial Plexus Blockage versus General Anesthesia for Upper Extremity Surgery: A Systematic Review and Meta-Analysis.

Rafael Llombart-Blanco, María Benlloch, Gonzalo Mariscal, Pablo Vera, Egor Polevoi, Ali Dway, Carlos Barrios, Rafael Llombart-Ais

Abstract readSystematic ReviewMeta-AnalysisComparative Study
In one paragraph

Synthesis in European surgical research. Europaische chirurgische Forschung. Recherches chirurgicales europeennes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Rafael Llombart-BlancoOrthopedic Surgery Department, University Clinic of Navarra, Pamplona, Spain.
María BenllochDepartment of Basic Medical Sciences, Catholic University of Valencia San Vicente Mártir, Valencia, Spain, maria.benlloch@ucv.es.
Gonzalo MariscalInstitute for Research on Musculoskeletal Disorders, School of Medicine, Catholic University of Valencia, Valencia, Spain.
Pablo VeraInstitute for Research on Musculoskeletal Disorders, School of Medicine, Catholic University of Valencia, Valencia, Spain.
Egor PolevoiTrauma center, La Salud Hospital, Valencia, Spain.
Ali DwayFaculty of Medicine, Al-Andalus University for Medical Sciences, Tartus, Syrian Arab Republic.
Carlos BarriosInstitute for Research on Musculoskeletal Disorders, School of Medicine, Catholic University of Valencia, Valencia, Spain.
Rafael Llombart-AisInstitute for Research on Musculoskeletal Disorders, School of Medicine, Catholic University of Valencia, Valencia, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis meta-analysis investigated differences in rebound pain and opioid consumption when using brachial plexus blockade (BPB) versus general anesthesia (GA) for upper limb surgery.

methodsFour databases were searched. Odds ratios (OR), mean differences (MD), and standard mean differences (SMD) with 95% confidence intervals (CIs) were calculated. Outcomes included were pain, opioid consumption, adverse events, and discharge time. The risk of bias was assessed.

resultsNine clinical trials involving 487 patients were included. BPB resulted in significantly lower pain scores within 2 h postoperatively (MD -4.57, 95% CI -5.76 to 3.38; participants = 263; studies = 5; I2 = 0%; p < 0.00001) but not from 6 to 24 h. Opioid consumption (mg) was lower in the BPB group in the first 24 h (SMD -0.85, 95% CI -1.41 to -0.29; participants = 188; studies = 3; I2 = 67%; p < 0.003). BPB was associated with fewer postoperative nausea/vomiting events (OR 0.19, 95% CI 0.10-0.33; participants = 326; studies = 6; I2 = 45%; p < 0.00001) and shorter hospital stay (SMD -1.20, 95% CI -1.73 to -0.66; participants = 213; studies = 4; I2 = 69%; p < 0.0001). There was no difference in the number of patients not requiring opioids from 24 to 48 h.

conclusionsBPB provided superior pain control at 2 h postoperatively and was associated with reduced opioid use, fewer adverse events, and shorter discharge time. No significant differences in pain scores were observed at 6-24 h or beyond 24 h, likely due to block wear-off. Despite this limitation, BPB still offered perioperative advantages over GA.

Indexed as

Anesthesia, GeneralBrachial Plexus BlockUpper ExtremityAnalgesics, OpioidHumansPostoperative PainAnalgesics, OpioidAnesthesiaBrachial plexus blockadeGeneral anesthesiaHospital dischargeOpioid-related disordersPostoperative pain

Identifiers

PMID41428588
PMCPMC12845516

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.