{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:31:09Z","timestamp":1787070669004,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,7]]},"abstract":"\n Background and Aims:<\/jats:title>\n The infraclavicular brachial plexus block (ICB) provides analgesia and anaesthesia of the upper limb. It is given using the classical or the more recently described costoclavicular (CC) approach at the level of cords. This systematic review aimed to assess which approach is better for the ICB in terms of onset, performance, and safety.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n This PROSPERO (vide registration number CRD42022361636) registered meta-analysis included randomised trials of patients undergoing upper limb surgery in ultrasound-guided ICB from MEDLINE, EMBASE, SCOPUS, and IRCTP from inception to March 2023. The quality of evidence was assessed using GradePro software. The primary outcomes were sensory and motor block onset time and the number of patients having complete block at 30 minutes. Secondary outcomes included block performance time (BPT), number of attempts, duration of the block, and any incidence of complications.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Five trials with 374 adult patients (classic = 185, CC = 189) were included. No significant difference was found in the sensory (Mean difference (MD): 1.44 minutes [95% confidence interval (CI): 3.06, 5.95]; I\n 2<\/jats:sup>\n = 95%; very low level of evidence (LOE);\n P<\/jats:italic>\n = 0.53) and motor block onset times (MD: 0.83 minutes [95% CI: 0.96, 2.62]; I\n 2<\/jats:sup>\n = 84%; very low LOE\n P<\/jats:italic>\n = 0.36) and BPT (MD: 5.06 seconds [95% CI: 38.50, 48.63]; I\n 2<\/jats:sup>\n = 98%; very low LOE;\n P<\/jats:italic>\n = 0.82) in classic and CC approach of ICB. Trial sequential analysis revealed our sample size to be 0.65% of the required sample size to achieve 80% power, deeming our study underpowered.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Costoclavicular approach was not superior or inferior to the classical technique for infraclavicular brachial plexus block. However, the quality of evidence is low and further studies are needed to corroborate the findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ija.ija_1124_23","type":"journal-article","created":{"date-parts":[[2024,6,6]],"date-time":"2024-06-06T08:05:00Z","timestamp":1717661100000},"page":"606-615","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Comparison of the classical approach and costoclavicular approach of ultrasound-guided infraclavicular block: A systematic review and meta-analysis"],"prefix":"10.4103","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8138-6202","authenticated-orcid":false,"given":"Heena","family":"Garg","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6640-9433","authenticated-orcid":false,"given":"Purva","family":"Makhija","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8863-415X","authenticated-orcid":false,"given":"Dhruv","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1140-5444","authenticated-orcid":false,"given":"Shailendra","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5281-9857","authenticated-orcid":false,"given":"Lokesh","family":"Kashyap","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,6,7]]},"reference":[{"issue":"8","key":"R1-20260505","first-page":"CD005487","article-title":"Infraclavicular brachial plexus block for regional anaesthesia of the lower arm","author":"Chin","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"R2-20260505","first-page":"139","article-title":"Infraclavicular brachial plexus blocks","volume":"9","author":"Macfarlane","year":"2009","journal-title":"Contin Educ Anaesth Crit Care 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