Impact of Combining Each Adjuvant, Morphine, Buprenorphine, and Fentanyl on Anaesthesia Onset Time and Postoperative Analgesia Compared to Other Combinations for Brachial Plexus Block: A Systematic Review and MetaAnalysis

Blocking Brachial plexus has become increasingly preferred in upper limb and shoulder surgeries because it provides reliable surgical anaesthesia, prolonged postoperative analgesia, limb immobilization, and decreases the requirement for general anaesthesia. and its associated adverse effects. Ultrasound guidance permits for precise deployment of needles and effective deposition of local anaesthetics, rapid onset of block, improved patient satisfaction, and a lower risk of vascular injury. Opioids such as morphine, fentanyl, and buprenorphine have been explored as adjuvants to local anaesthetics to further enhance block characteristics. This meta-analysis examined the effectiveness and safety of incorporating morphine, fentanyl, or buprenorphine as adjuncts to brachial plexus anaesthesia in patients undergoing arthroscopic shoulder or other upper-limb procedures.