{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T05:45:46Z","timestamp":1793771146174,"version":"4.6.1"},"reference-count":34,"publisher":"BMJ","issue":"4","funder":[{"name":"Berufsverband Deutscher An\u00e4sthesisten e.V."},{"name":"Deutsche Gesellschaft f\u00fcr An\u00e4sthesiologie und Intensivmedizin e.V."},{"name":"German Research Foundation DFG","award":["MU4688-1-1"],"award-info":[{"award-number":["MU4688-1-1"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2024,11,20]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Regional anesthesia is frequently used for upper limb surgeries and postoperative pain control. Different approaches to brachial plexus blocks are similarly effective but may differ in the frequency and severity of iatrogenesis. We, therefore, examined large-scale registry data to explore the risks of typical complications among different brachial plexus block sites for regional anesthesia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>26,947 qualifying adult brachial plexus blocks (2007\u20132022) from the Network for Safety in Regional Anesthesia and Acute Pain Therapy registry were included in a retrospective cohort analysis. Interscalene, supraclavicular, infraclavicular, and axillary approaches were compared for block failure and bloody punctures using generalized estimating equations. For continuous procedures, we analyzed the influence of the approach on catheter failure, neurological disorders, and infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The axillary plexus block had the highest risk of block failure (adjusted OR, 2.3; 95% CI 1.02 to 5.1; p=0.04), catheter failure (adjusted OR, 1.4; 95% CI 1.1 to 2.0; p=0.02), and neurological dysfunction (adjusted OR, 3.0; 95% CI 1.5 to 5.9; p=0.002). There was no statistically significant difference among block sites for bloody punctures, while infraclavicular blocks had the highest odds for catheter-related infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The axillary approach to the brachial plexus had the highest odds for block failure and neurological dysfunction after catheter placement, as well as a significant risk for catheter failure. However, considering that the axillary approach precludes other complications such as pneumothorax, none of the four common approaches to the brachial plexus has a fundamentally superior risk profile.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2024-105862","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T11:10:53Z","timestamp":1735643453000},"page":"443-453","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Risk profiles of common brachial plexus block sites: results from the net-ra registry"],"prefix":"10.1136","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0981-074X","authenticated-orcid":false,"given":"Christine","family":"Kubulus","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University, Saarbr\u00fccken, Germany"},{"name":"OUTCOMES RESEARCH Consortium, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maral","family":"Saadati","sequence":"additional","affiliation":[{"name":"Freelance Statistician, Saadati Solutions, Ladenburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas M","family":"M\u00fcller-Wirtz","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1922-5555","authenticated-orcid":false,"given":"William M","family":"Patterson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Cleveland Clinic, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Gottschalk","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care Medicine and Pain Medicine, Diakovere Henriettenstift and Friederikenstift, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rene","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care Medicine and Pain Medicine, Marienhospital, Stuttgart, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Volk","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"key":"2026043012300843000_51.4.443.1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1097\/AIA.0b013e31821a0284","article-title":"Regional anesthesia procedures for shoulder and upper arm surgery upper extremity update--2005 to 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