Volume 29, Issue 157, March 2025

The difference between general anesthesia and peripheral nerve block in terms of postoperative functional recovery after orthopaedic upper limb surgery: Systematic review

Abdurahman Talal Bahha¹, Bashir Abdulmalik Amin², Suhail Salman Alfaifi³, Hammad Sned Alharbi², Abdullah Kamel Alhashmi Alamer⁴, Mohammed Abdulaziz Alduayj⁵, Maram Abdulaziz Aldeej⁵, Shifaa Sharaf Aljefri⁴

¹Anesthesia and Pain Management Consultant, King Abdullah Medical City, Makkah, Saudi Arabia
²Anesthesia Resident, Alnoor Specialist Hospital, Makkah, Saudi Arabia
³Anesthesia Resident, King Abdullah Medical City, Makkah, Saudi Arabia
⁴Medical Intern, Ibn Sina National Collage for Medical Studies, Jeddah, Saudi Arabia
⁵Medical Intern, College of Medicine, King Saud University, Riyadh, Saudi Arabia

ABSTRACT

Background: Following upper limb procedures, a significant percentage of patients report moderate to severe postoperative pain, and they also tend to consume more opioids over 24 hours following the procedure. We carried out a systematic review of papers evaluating the effects of peripheral nerve block vs GA on functional recovery following upper limb surgery. Method: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed in the conduct of this investigation. Our comprehensive search approach used CENTRAL, MEDLINE, Scopus, and EMBASE from January 2012 to September 2024. Serch terms include, Brachial plexus, peripheral anesthesia, upper limb surgery, FR, nerve block, and postoperative recovery. Result: Five papers were included in this review. Three studies employed supraclavicular nerve block, while one study used infraclavicular block to assess wrist clinical results. Among the surgical indications were distal radial fracture fixation, ischemia after tourniquet-induced upper limb surgery, and wrist surgeries (including carpal tunnel release, ganglion cyst excision, wrist mass excision, metacarpal fracture, hardware removal, fracture correction, arthroscopic surgery, and ligament repair). Conclusion: Early postoperative brachial plexus block pain management did not significantly vary from general anesthesia in patients undergoing orthopedic forearm surgery or surgical stabilization of distal radial fractures.

Keywords: General anesthesia, peripheral nerve block, functional recovery, upper limb surgery

Medical Science, 2025, 29, e45ms3535

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DOI: https://doi.org/10.54905/disssi.v29i157.e45ms3535

Published: 01 March 2025