NEUROLOGICAL SAFETY IN BRACHIAL PLEXUS BLOCK: COMPARISON OF BLIND, ULTRASOUND-GUIDED, AND NERVE STIMULATION-GUIDED TECHNIQUES

Abstract

Brachial plexus blocks are among the main regional anesthesia techniques used for surgical procedures involving the upper limb, providing effective anesthesia, excellent postoperative pain control, reduced opioid consumption, and earlier functional recovery. The refinement of these techniques has contributed to increased safety and quality of anesthetic care, particularly with the incorporation of technological resources that enable greater precision in the localization of neural structures. Although ultrasonography has revolutionized the practice of regional anesthesia by allowing real-time visualization of the brachial plexus, needle tip, and spread of the local anesthetic, other localization methods, such as nerve stimulation and techniques based on anatomical landmarks, continue to be widely used in different clinical settings. Therefore, understanding the scientific evidence related to each method remains relevant, particularly with regard to neurological safety and the prevention of complications. Nerve injuries resulting from brachial plexus blocks, although uncommon, may lead to significant functional consequences, compromising patient recovery and increasing procedure-related morbidity. Thus, identifying strategies that may help minimize these risks remains a constant concern in anesthetic practice and an important topic for scientific research.