Virginia Mason Medical Center, Seattle, WA, USA.
Reg Anesth Pain Med. 2010 Mar-Apr;35(2 Suppl):S1-9. doi: 10.1097/AAP.0b013e3181d22fe0.
The American Society of Regional Anesthesia and Pain Medicine charged an expert panel to examine the evidence basis for ultrasound guidance as a nerve localization tool in the clinical practices of regional anesthesia and interventional pain medicine.
The panel searched, examined, and assessed the literature of ultrasound-guided regional anesthesia (UGRA) from the past 20 years. The qualities of studies were graded using the Jadad score. Strength of evidence and recommendations were graded using an accepted rating tool.
The panel made specific literature-based assessments concerning the relative advantages and limitations of UGRA relative to traditional nerve localization methods as they pertained to block characteristics and complications. Assessments and recommendations were made for upper and lower extremity, neuraxial, and truncal blocks and include pediatrics and interventional pain medicine.
Ultrasound guidance improves block characteristics (particularly performance time and surrogate measures of success) that are often block specific and that may impart an efficiency advantage depending on individual practitioner circumstances. Evidence for UGRA impacting patient safety is currently limited to the demonstration of improvements in the frequency of surrogate events for serious complications.
美国区域麻醉与疼痛医学学会委托一个专家小组，检查超声引导作为区域麻醉和介入疼痛医学临床实践中神经定位工具的证据基础。
该小组对过去 20 年的超声引导区域麻醉（UGRA）文献进行了搜索、检查和评估。使用 Jadad 评分对研究质量进行分级。使用公认的评级工具对证据强度和建议进行分级。
该小组根据 UGRA 相对于传统神经定位方法的相对优势和局限性，就与阻滞特征和并发症相关的问题，对 UGRA 进行了具体的文献评估。评估和建议涵盖了上肢、下肢、脊柱和躯干阻滞，包括儿科和介入疼痛医学。
超声引导提高了阻滞特征（尤其是操作时间和成功的替代指标），这些特征通常是特定于阻滞的，并且根据个体从业者的情况可能具有效率优势。目前，超声引导对患者安全性的影响的证据仅限于证明替代严重并发症的发生率的提高。
