Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Department of Emergency Medicine, Chiayi, Taiwan.
Tzu Chi University, School of Medicine, Hualien, Taiwan.
West J Emerg Med. 2022 Oct 24;23(6):878-885. doi: 10.5811/westjem.2022.8.57552.
Regional anesthesia (RA) has become a prominent component of multimodal pain management in emergency medicine (EM), and its use has increased rapidly in recent decades. Nevertheless, there is a paucity of data on how RA practice has evolved in the specialty. In this study we sought to investigate how RA has been implemented in EM by analyzing trends of published articles and to describe the characteristics of the published research.
We retrieved RA-related publications from the SciVerse Scopus database from inception to January 13, 2022, focusing on studies associated with the use of RA in EM. The primary outcome was an analysis of trend based on the number of annual publications. Other outcomes included reports of technique diversity by year, trends in the use of individual techniques, and characteristics of published articles. We used linear regression analysis to analyze trends.
In total, 133 eligible publications were included. We found that overall 23 techniques have been described and results published in the EM literature. Articles related to RA increased from one article in 1982 to 18 in 2021, and the rate of publication has increased more rapidly since 2016. Reports of lower extremity blocks (60.90%) were published most frequently in ranked-first aggregated citations. The use of thoracic nerve blocks, such as the erector spinae plane block, has increased exponentially in the past three years. The United States (41.35%) has published the most RA-related articles. Regional anesthesia administered by emergency physicians (52.63%) comprised the leading field in published articles related to RA. Most publications discussed single-shot (88.72%) and ultrasound-guided methods (55.64%).
This study highlights that the number of published articles related to regional anesthesia in EM has increased. Although RA research has primarily focused on lower extremity blocks, clinical researchers continue to broaden the field of study to encompass a wide spectrum of techniques and indications.
区域麻醉（RA）已成为急诊医学（EM）多模式疼痛管理的重要组成部分，其在近几十年来的应用迅速增加。然而，关于该专业中 RA 实践如何演变的数据却很少。在这项研究中，我们通过分析已发表文章的趋势来研究 RA 在 EM 中的应用情况，并描述已发表研究的特征。
我们从 SciVerse Scopus 数据库中检索了从创建到 2022 年 1 月 13 日与 RA 在 EM 中使用相关的 RA 相关出版物。主要结果是基于每年发表的文章数量进行分析的趋势。其他结果包括每年技术多样性的报告、个别技术使用的趋势以及已发表文章的特征。我们使用线性回归分析来分析趋势。
共有 133 篇符合条件的出版物被纳入。我们发现，在 EM 文献中已经描述和发表了 23 种技术。与 RA 相关的文章从 1982 年的一篇增加到 2021 年的 18 篇，自 2016 年以来，发表的速度更快。排名第一的汇总引用中发表了最多关于下肢阻滞（60.90%）的报告。过去三年中，胸神经阻滞（如竖脊肌平面阻滞）的使用率呈指数级增长。美国（41.35%）发表了最多的 RA 相关文章。在与 RA 相关的已发表文章中，由急诊医师实施的区域麻醉（52.63%）是领先领域。大多数出版物讨论了单次注射（88.72%）和超声引导方法（55.64%）。
本研究表明，与 EM 中的区域麻醉相关的已发表文章数量有所增加。尽管 RA 研究主要集中在下肢阻滞，但临床研究人员继续拓宽研究领域，涵盖广泛的技术和适应症。
