EFFICACY AND SAFETY OF ULTRASOUND-GUIDED NERVE BLOCKS COMPARED TO TRADITIONAL LANDMARK-BASED TECHNIQUES
Main Article Content
Keywords
Ultrasound-guided nerve block, landmark-based nerve block, regional anesthesia, block success, pain management, complications.
Abstract
Background: Ultrasound-guided nerve blocks (UGNB) have emerged as a promising alternative to traditional landmark-based techniques (LMBT) in regional anesthesia. However, the comparative efficacy and safety of these approaches remain a subject of ongoing research.
Objective: This systematic review evaluates the efficacy and safety of UGNB compared to LMBT across various clinical settings, including perioperative care, chronic pain management, and pediatric anesthesia.
Methods: A comprehensive literature search was conducted following PRISMA guidelines, including studies from PubMed, Embase, MEDLINE, and Cochrane Library up to March 2025. Randomized controlled trials (RCTs), cohort studies, and systematic reviews comparing UGNB and LMBT were included. Primary outcomes were block success rate and pain scores, while secondary outcomes included complication rates, procedure time, and patient satisfaction. Risk of bias was assessed using Cochrane RoB 2 and ROBINS-I tools, and evidence certainty was graded using the GRADE approach.
Results: Analysis of 9 studies (including RCTs and meta-analyses) demonstrated that UGNB significantly improved block success rates (100% vs. 30–64% in LMBT), reduced pain scores, and decreased complications. UGNB also showed faster onset and longer duration of analgesia. In pediatric populations, UGNB achieved higher first-attempt success (100% vs. 64%) and fewer complications. For chronic pain conditions (e.g., migraines, shoulder pain), UGNB provided superior pain relief and reduced analgesic use. Large meta-analyses confirmed fewer failed attempts and higher patient satisfaction with UGNB.
Conclusion: UGNB is superior to LMBT in terms of efficacy, safety, and patient outcomes across diverse clinical scenarios. The evidence supports adopting UGNB as the standard of care in regional anesthesia when feasible. Future research should focus on cost-effectiveness and implementation in resource-limited settings.
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Dr. Aisha Khader
Assistant Professor, Anesthesiology, MM Institute of Medical Sciences and Research, Mullana, Ambala, Haryana.
Dr. Hardeep Bariar
Professor, Anesthesiology, Adesh Medical College and Hospital Mohri, Haryana.
Dr. Khushdeep Singla
Assistant Professor, Radiodiagnosis, Adesh institute of Medical Sciences and Research, Bathinda, Punjab.
Tapkirat singh monga
Assistant Professor, Anesthesiology, Ajay Sangaal institute of medical sciences and research, Jhinjana, U.P.
Dr. Reema Aggarwal
Assistant Professor, Anesthesiology, Adesh Medical College and Hospital, Mohri, Haryana.
Dr. Pankaj Kumar
Assistant Professor, Anesthesiology, Adesh Medical College and Hospital, Mohri, Haryana.