Comparison of interscalene block with costoclavicular block for arthroscopic shoulder surgery: A meta-analysis

Background: The impact of interscalene block versus costoclavicular block on the analgesia for arthroscopic shoulder surgery is unclear, and this meta-analysis aims to study the analgesic efficacy of interscalene block versus costoclavicular block for arthroscopic shoulder surgery. Methods: We have searched several databases including PubMed, EMbase, Web of science, EBSCO and Cochrane library databases, and randomized controlled trials assessing the effect of interscalene block versus costoclavicular block for arthroscopic shoulder surgery were involved. This meta-analysis was conducted by the fixed-effect model or random-effect model based on the heterogeneity. Results: Four randomized controlled trials were included in this meta-analysis. For patient undergoing arthroscopic shoulder surgery, interscalene block and costoclavicular block demonstrated comparable pain scores at 30 minute (mean difference [MD] = 0; 95% confidence interval [CI] = −0.20 to 0.21; P = .96), pain scores at 1 hour (MD = −0.02; 95% CI = −0.22 to 0.19; P = .87), pain scores at 3 hour (MD = −0.04; 95% CI = −0.27 to 0.19; P = .73), pain scores at 6 hour (MD = −0.57; 95% CI = −1.77 to 0.63; P = .35), pain scores at 12 hour (MD = 0; 95% CI = −0.06 to 0.07; P = .93), pain scores at 24 hour (MD = 0; 95% CI = −0.06 to 0.07; P = .96), time to first rescue analgesia (MD = 76.67; 95% CI = −19.23 to 172.56; P = .12), nausea and vomiting (MD = 0.69; 95% CI = 0.36 to 1.32; P = .27). Conclusion: Interscalene block and costoclavicular block are comparable to control the analgesia for arthroscopic shoulder surgery.