TY - JOUR
T1 - Analgesic efficacy of ultrasound-guided regional anesthesia
T2 - A meta-analysis
AU - Gelfand, Harold J.
AU - Ouanes, Jean Pierre P.
AU - Lesley, Maggie R.
AU - Ko, Phebe S.
AU - Murphy, Jamie D.
AU - Sumida, Shawn M.
AU - Isaac, Gillian R.
AU - Kumar, Kanupriya
AU - Wu, Christopher L.
N1 - Funding Information:
Supported by the Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University, Baltimore, MD, USA.
Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2011/3
Y1 - 2011/3
N2 - Study Objective: To determine if the use of ultrasound guidance (vs non-ultrasound techniques) improves the success rate of nerve blocks. Design: Meta-analysis of randomized controlled trials (RCTs) in the published literature. Setting: University medical center. Measurements: 16 RCTs of patients undergoing elective surgical procedures were studied. Patients underwent ultrasound-guided or non-ultrasound techniques (nerve stimulation, surface landmark) for peripheral nerve blocks. Success rates were measured. Main Results: Ultrasound guidance (vs all non-ultrasound techniques) was associated with a significant increase in the success rate of nerve blocks [relative risk (RR) = 1.11 (95% confidence interval [CI]: 1.06 to 1.17, P < 0.0001]). When compared with nerve stimulator techniques only, ultrasound guidance was still associated with an increase in the success rate (RR = 1.11 [95% CI: 1.05 to 1.17, P = 0.0001]). For specific blocks, ultrasound guidance (vs all non-ultrasound) was associated with a significant increase in successful brachial plexus (all) nerve blocks (RR = 1.11 [95% CI: 1.05 to 1.20, P = 0.0001]), sciatic popliteal nerve block (RR = 1.22 [95% CI: 1.08 to 1.39, P = 0.002]) and brachial plexus axillary nerve block (RR = 1.13 [95% CI: 1.00 to 1.26, P = 0.05]) but not brachial plexus infraclavicular nerve block (RR = 1.25 [95% CI: 0.88 to 1.76, P = 0.22]). Conclusions: Ultrasound-guided peripheral nerve block is associated with an increased overall success rate when compared with nerve stimulation or other methods. Ultrasound-guided techniques also increase the success rate of some specific blocks.
AB - Study Objective: To determine if the use of ultrasound guidance (vs non-ultrasound techniques) improves the success rate of nerve blocks. Design: Meta-analysis of randomized controlled trials (RCTs) in the published literature. Setting: University medical center. Measurements: 16 RCTs of patients undergoing elective surgical procedures were studied. Patients underwent ultrasound-guided or non-ultrasound techniques (nerve stimulation, surface landmark) for peripheral nerve blocks. Success rates were measured. Main Results: Ultrasound guidance (vs all non-ultrasound techniques) was associated with a significant increase in the success rate of nerve blocks [relative risk (RR) = 1.11 (95% confidence interval [CI]: 1.06 to 1.17, P < 0.0001]). When compared with nerve stimulator techniques only, ultrasound guidance was still associated with an increase in the success rate (RR = 1.11 [95% CI: 1.05 to 1.17, P = 0.0001]). For specific blocks, ultrasound guidance (vs all non-ultrasound) was associated with a significant increase in successful brachial plexus (all) nerve blocks (RR = 1.11 [95% CI: 1.05 to 1.20, P = 0.0001]), sciatic popliteal nerve block (RR = 1.22 [95% CI: 1.08 to 1.39, P = 0.002]) and brachial plexus axillary nerve block (RR = 1.13 [95% CI: 1.00 to 1.26, P = 0.05]) but not brachial plexus infraclavicular nerve block (RR = 1.25 [95% CI: 0.88 to 1.76, P = 0.22]). Conclusions: Ultrasound-guided peripheral nerve block is associated with an increased overall success rate when compared with nerve stimulation or other methods. Ultrasound-guided techniques also increase the success rate of some specific blocks.
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U2 - 10.1016/j.jclinane.2010.12.005
DO - 10.1016/j.jclinane.2010.12.005
M3 - Article
C2 - 21377070
AN - SCOPUS:79952365982
SN - 0952-8180
VL - 23
SP - 90
EP - 96
JO - Journal of Clinical Anesthesia
JF - Journal of Clinical Anesthesia
IS - 2
ER -