Table 1.

Relevant differences between outcome data for peripheral regional anaesthetic techniques during the last 20 yr (2003–23). TKA, total knee arthroplasty.

Regional anaesthetic technique	Summary of outcome between October 4 2003 and October 3, 2013	Summary of outcome between October 4, 2013 and February 16, 2023	Comparison between outcome data
Interscalene brachial plexus block	17 RCTs, 11 non-RCTs Adequate pain therapy, relatively high incidence of complications (associated with large volumes of local anaesthetics), comparisons with subacromial infiltration	11 RCTs, four non-RCTs Still well published, adequate pain therapy, less incidence of complications (because of more experience with ultrasound), one study (indication: mastectomy) outside the anatomical supply area	Slight decrease in scientific publications, sufficient pain therapy, decrease of reported complications
Supraclavicular brachial plexus block	One RCT, six non-RCTs Limited data, high incidence of phrenic nerve block, complications increase with increasing doses of local anaesthetics	Three RCTs, zero non-RCTs Still not well published, data in the field of forearm fracture show a high conversion rate to general anaesthesia	Still limited data, present data indicate an unreliable analgesic effect, possible surgical indications (e.g. elbow surgery) still not investigated in comparative RCTs
Infraclavicular brachial plexus block	One RCT, five non-RCTs Adequate pain therapy, shorter discharge times as compared with general anaesthesia, vascular puncture and high volumes of local anaesthetic are risks	One RCT, zero non-RCTs Adequate pain therapy with low rate of complications	Decrease in publications, adequate pain therapy, low rate of complications
Axillary approach to the brachial plexus	Two RCTs, nine non-RCTs Outcome data are insufficient, short-term management is improved, permanent nerve damage is described	No publications	No adequate studies in this field were published during the past 10 yr.
Axillary nerve block	No publications	One RCT, zero non-RCT Insufficient for shoulder surgery	Only one RCT during the last 20 yr, the technique is insufficient for shoulder surgery
Femoral nerve block	42 RCTs, five non-RCTs Large number of studies, sufficient pain relief after knee surgery (better as wound or intra-articular infiltration), chronic postsurgical pain not affected, insufficient pain therapy after hip fracture	26 RCTs, 14 non-RCTs Many studies in the field of hip surgery (questionable clinical indication), sufficient technique for knee surgery, because of reported postoperative falls, more peripheral techniques for knee surgery should be considered	Still many publications in the field of hip surgery without an anatomical correlate, sufficient for knee surgery, but more peripheral techniques should be considered because of reported postoperative falls
Saphenous nerve block	Eight RCTs, one non-RCT Effective pain therapy after TKA and knee arthroscopy, no motor block	18 RCTs, six non-RCTs Adequate pain therapy and improved functional recovery after knee surgery, better effect after TKA than after anterior cruciate ligament reconstruction	The increase in publications confirm the trend towards motor-sparing and more peripheral nerve block techniques.
Sciatic nerve block	23 RCTs, four non-RCTs Effective pain therapy, improved patient satisfaction	Three RCTs, one non-RCT Sufficient pain therapy	The significant decrease of publications indicate the trend to motor-sparing regional anaesthetic techniques, if performed, sciatic block is sufficient.
Psoas compartment block	Five RCTs, one non-RCT Sufficient pain therapy for hip surgery, equal to epidural anaesthesia, high incidence of epidural spread of local anaesthetic	One RCT, zero non-RCT Surgeon-performed, effective for hip surgery, no information regarding pharmacodynamic values	The significant decrease in publications indicate the trend to more peripheral regional anaesthetic techniques, anaesthesiologists do not study this technique anymore.
Cervical plexus block	12 RCTs, zero non-RCT High patient satisfaction for thyroid and carotid surgery	15 RCTs, one non-RCT Still well published with a broader spectrum of indications including ear surgery, only minor complications reported	The numbers of publications are similar between the decades, the spectrum of indications increase, further indications could be included in RCT (e.g. clavicle surgery)
Intercostal nerve block	Nine RCTs, one non-RCT Good pain therapy for rib fractures, thoracic surgery, and laparoscopic procedures, postsurgical pulmonary function similar to thoracic epidural anaesthesia	11 RCTs, eight non-RCTs Additional procedures are now included, surgical performance of block appears as less efficient	The number of publications increased with a broader spectrum of indications. The block should be performed by anaesthesiologists.
Ilioinguinal/iliohypogastric nerve block	Six RCTs, two non-RCTs Earlier hospital discharge after hernia repair compared with pure general anaesthesia	Four RCTs, zero non-RCT Caesarean section is now included in the spectrum of indications, safe technique	The number of indications increased (Caesarean section), can be considered as safe technique