Trends and Future Avenues: A Bibliometric Analysis of the 150 Most Cited Papers on Brachial Plexus Blocks, from 1993 to 2023
Introduction
Bibliometric studies have been used to identify trends in publications and help set research priorities. These studies have been useful in the characterization of global publications in anesthesiology and within the field of regional anesthesia.
Study Goals
The objective of this study is to conduct a bibliometric analysis of the 150 most-cited publications on brachial plexus blocks (BPB) from the years 1993 to 2023, in order to:
1) Understand existing trends in publication characteristics and content
2) Identify potential avenues for future research
Methods
•Database: Articles from 1/1/1993 to 7/1/2023 were screened from the Science Citation Index-Expanded (SCI-Expanded) of the Web of Science Core Collection (WoS)
•Search terms: ”brachial plexus block”, “axillary nerve block”, “infraclavicular nerve block”, “supraclavicular nerve block”, and/or “interscalene nerve block”
•Inclusion criteria: full-length journal articles, letters, and reviews limited to anesthesiology
•Exclusion criteria: articles with animal models, non-English papers
•Top 150 articles with the most citations were identified from a total of 1140
•Each paper was evaluated to categorize the content of the paper and to identify block type, study type, first author gender, journal, and country of publication
•Gender of the first author was identified by utilizing images of authors and/or determining if the first name is commonly known to be male or female
•Statistical analysis: Mann-Whitney U and Kruskal-Wallis
Findings
•14 unique journals represented, with the top 3 journals with the most-cited studies being: 1) Anesthesia and Analgesia (n=43, 29%), 2) Regional Anesthesia and Pain Medicine (n=39, 26%), 3) Anesthesiology (n=20, 13%)
•26 distinct countries represented, with the top 3 countries with the most cited studies being: 1) USA (n=50, 33%), 2) Canada (n=32, 21%), and 3) France (n=9, 6%)
•There are significantly higher median average citations per year for studies conducted between 2009 and 2023 than between 1993 and 2008 (6.61 vs. 4.11, p < 0.001).
•Of types of studies, meta-analysis had the highest average citations per year at 12.89 (H(6) = 18.2, p = 0.006).
•The adjuvant medications for BPB that were studied in the top cited papers were dexamethasone (n=12), clonidine (n=5), precedex (n=3), opioids (n=4), buprenorphine (n=2), magnesium (n=2), midazolam (n=1), gabapentin (n=1), and liposomal bupivacaine (n=1)
Conclusions
•Adjuvant medications for BPB was the most popular topic within the top 150 most-cited papers, and thus a strong avenue for future research.
•Within these papers, perineural and intravenous dexamethasone and their ability to increase the duration of analgesia in BPB was most frequently studied
•There is a wide representation of countries in the most cited papers indicating a global interest in brachial plexus block research.
•Female first authors are starkly underrepresented in the top 150 most-cited papers. Further research is needed to understand the contributory factors for this gender disparity. Addressing these factors can allow for more representation in the field of regional anesthesiology
