Ultrasound guidance for neuraxial, peripheral nerve blocks in children: Cochrane

  • Guay J & al.
  • Cochrane Database Syst Rev
  • 27 Feb 2019

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Ultrasound guidance for performing neuraxial or peripheral nerve block in children probably decreases the risk for failure.
  • Pain scores also are decreased at an hour after surgery when ultrasound guidance is used.
  • Risks for minor complications are unaffected.
  • 5 studies are in progress.

Why this matters

  • This Cochrane review updates a 2016 review and adds 13 new trials, but the conclusions remain. 

Key results

  • Failure risk is reduced with ultrasound guidance: risk difference, –0.16 (95% CI, –0.25 to –0.07); 22 trials; n=1789; evidence quality moderate.
  • Small-moderate postsurgery pain reduction with ultrasound guidance: standardized mean difference: –0.41 (95% CI, –0.74 to –0.07); 15 trials; n=982 participants; evidence quality moderate.

Study design

  • 33 studies included, with 2293 children; block with ultrasound guidance compared with another localization method.
  • Funding: Universities, others.

Limitations

  • Limitations are those of the included studies.

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