Regional Nerve Blocks for Trauma Pain in the Emergency Department: A Systematic Review of Efficacy and Safety.

Effective acute pain management in the emergency department is essential, especially for patients with fractures, dislocations, and other musculoskeletal injuries. Conventional approaches like systemic opioids and procedural sedation, while commonly used, can lead to side effects such as respiratory issues, nausea, extended emergency department stays, and potential opioid dependence. In recent years, ultrasound-guided nerve blocks have gained attention as a safer and more targeted method of pain control that can reduce reliance on opioids. This review explored how ultrasound-guided nerve blocks compare to traditional pain management strategies in terms of effectiveness, safety, and clinical outcomes. A detailed search was conducted across several major medical databases, including PubMed, Scopus, Web of Science, the Cochrane Central Register of Controlled Trials, and the Virtual Health Library. Search terms focused on ultrasound, anesthesia, nerve blocks, and emergency care. The review included only randomized controlled trials published in English that involved adult patients receiving ultrasound-guided nerve blocks for acute pain in emergency settings. The main outcomes assessed were pain relief (measured using validated scales), opioid use, time spent in the emergency department, patient satisfaction, and adverse events. Out of 3,299 studies initially identified, 2,430 remained after removing duplicates. After reviewing 60 full-text articles, nine met the inclusion criteria for analysis. The results showed that ultrasound-guided nerve blocks provided more rapid and sustained pain relief than standard treatments, with a noticeable reduction in opioid use. They were also linked to shorter emergency department stays, higher levels of patient satisfaction, and a low rate of complications when carried out by trained providers. These findings suggest that ultrasound-guided nerve blocks can be a highly effective first-line option for managing acute pain in trauma patients. Still, further studies are recommended to optimize their use and encourage broader implementation in emergency care settings.