Abu Halimah Jalal, Zalah Ali A, Alammari Arwa H, Basowed Shorog B, Mobarki Abdullkarim T, Khawaji Ethar A, Arishi Revan A, Almohammed Rawan S, Almubarak Alzahra A, Buhulaigah Bayan A
General Surgery, Jazan University, Jazan, SAU.
Medicine, Jazan University, Jazan, SAU.
Cureus. 2025 Apr 11;17(4):e82073. doi: 10.7759/cureus.82073. eCollection 2025 Apr.
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.
在急诊科进行有效的急性疼痛管理至关重要，尤其是对于骨折、脱位及其他肌肉骨骼损伤的患者。全身使用阿片类药物和程序性镇静等传统方法虽常用，但可能导致呼吸问题、恶心、急诊科停留时间延长以及潜在的阿片类药物依赖等副作用。近年来，超声引导下神经阻滞作为一种更安全、更具针对性的疼痛控制方法受到关注，它可以减少对阿片类药物的依赖。本综述探讨了超声引导下神经阻滞在有效性、安全性和临床结果方面与传统疼痛管理策略相比如何。在包括PubMed、Scopus、Web of Science、Cochrane对照试验中央注册库和虚拟健康图书馆在内的几个主要医学数据库中进行了详细检索。检索词集中在超声、麻醉、神经阻滞和急诊护理。该综述仅纳入以英文发表的随机对照试验，这些试验涉及在急诊环境中接受超声引导下神经阻滞治疗急性疼痛的成年患者。评估的主要结果包括疼痛缓解（使用经过验证的量表测量）、阿片类药物使用情况、在急诊科的停留时间、患者满意度和不良事件。在最初识别出的3299项研究中，去除重复项后还剩2430项。在审查了60篇全文文章后，有9篇符合纳入分析的标准。结果表明，超声引导下神经阻滞比标准治疗能提供更快速、持续的疼痛缓解，阿片类药物使用量明显减少。由训练有素的医护人员实施时，还与急诊科停留时间缩短、患者满意度提高以及并发症发生率低有关。这些发现表明，超声引导下神经阻滞可能是管理创伤患者急性疼痛的一种非常有效的一线选择。不过，建议进一步研究以优化其使用，并鼓励在急诊护理环境中更广泛地实施。
