Impact of supraclavicular versus axillary brachial plexus block on long-term pain, functionality, and return-to-work outcomes in 6692 surgical procedures

BACKGROUND AND OBJECTIVES We investigated long-term pain and functionality outcomes following the supraclavicular and axillary brachial plexus block as regard to determine whether there are differences in outcomes following both blocks. DESIGN Observational study SETTING Patients scheduled for elective distal surgery of the upper extremity in 22 private hand surgery centres, between November 2011 and May 2016, were included. PATIENTS A total of 6692 ASA 1–2 patients, undergoing elective day-case surgery on the upper extremity under either single shot supraclavicular or axillary brachial plexus regional anaesthesia. MAIN OUTCOME MEASURES Rating-scales on pain and functionality were obtained preoperatively, at day 1, 6 weeks, and at 3 and 12 months postoperatively. In addition, patients time to return to work was obtained. RESULTS No difference was detected in pain and functionality scores between supraclavicular and axillary block patients from 6 weeks up to 12 months postoperatively, except for less pain following axillary block at day-one and during use at 6 weeks. CONCLUSIONS The current study reports no superiority of one block over the other in terms of long-term postoperative pain, functionality, and return-to-work outcome. Anaesthetists are therefore free to choose between the supraclavicular and axillary brachial plexus block based on personal preference.