Combination of shorter and longer-acting local anesthetics (LA) vs. longer-acting LA for brachial plexus block: Systematic review and meta-analysis of randomized clinical trials
Authors' conclusion
Our meta-analysis of RCTs indicate that combination of shorter and long acting LAs did not provide benefit in terms of onset time while leading to notably shorter durations of sensory and motor blockade compared to longer acting LA alone when used in brachial plexus blocks.
Study context
- Population
- Adults receiving brachial plexus block11 randomized clinical trials (RCTs)
- Comparison
- Combination of shorter- and longer-acting LA vs longer-acting LA alone
- Outcome
- Sensory and motor block onset times
Pooled result
As reported in the abstract
Combination LA vs Long-acting LAMD, min (95 % CI)
Sensory onset time
−0.44(−0.89 to 0.02)
Combination LA vs Long-acting LAMD (95 % CI)
Motor onset
0.01(−1.30 to 1.32)
Further pooled results
Duration of sensory and motor blockade
- Shorter duration of sensory and motor blockade with combination LA
Other secondary outcomes (duration of analgesia, conversion to general anesthesia (GA))
- No differences
Original publication
Combination of shorter and longer-acting LA vs. longer-acting LA for brachial plexus block: Systematic review and meta-analysis of randomized clinical trials. J Clin Anesth. Published 22 September 2025. doi:10.
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