Effects of single‐injection vs. continuous brachial plexus blocks for shoulder surgeries on patient‐reported outcomes: a systematic review and meta‐analysis with trial sequential analysis of randomised controlled trials

The study compared the effects of single-injection and continuous brachial plexus blocks on patient-reported outcomes following shoulder surgery. The analysis included 20 randomised controlled trials with a total of 1198 patients. Continuous blocks were associated with lower pain at rest at 12, 24, and 48 hours post-surgery, with mean differences of −1.96, −1.66, and −1.18 points respectively. Pain on movement was evaluated only at 24 and 48 hours with differences of −2.04 and −1.30 points. The results of continuous techniques met or exceeded the minimal clinically important differences in pain scores. Continuous brachial plexus blocks are associated with better pain control at rest and other patient-centred outcomes, while effects on dynamic pain and long-term functional recovery remain uncertain.