Ahmed Saba, Subramanian Amudhavan, Siddiqi Arzoo, Ramachandran Vignesh, Kaynat Bushra, Masood Malghalara, Dogar Sannia Y, Bilal Ali
Anaesthesia and Critical Care, Health Service Executive (HSE) Kerry Community Services, Kerry, IRL.
Anaesthesiology, Aneurin Bevan University Health Board, Newport, GBR.
Cureus. 2025 Jul 14;17(7):e87918. doi: 10.7759/cureus.87918. eCollection 2025 Jul.
This systematic review evaluates the comparative effectiveness of ultrasound and computed tomography (CT) in guiding regional anesthesia, with a focus on block accuracy, anesthetic spread, clinical efficacy, and procedural safety. A total of seven high-quality clinical studies were included, encompassing a range of nerve blocks such as celiac plexus, interscalene, intertransverse, and erector spinae plane blocks. Ultrasound guidance consistently demonstrated outcomes that were equivalent or superior to CT guidance in terms of anesthetic distribution, pain control, and patient satisfaction. In most cases, ultrasound enabled real-time visualization, minimized procedural complications, and eliminated radiation exposure while maintaining a high degree of accuracy, as validated by CT or MRI in select trials. CT retained value primarily as a secondary validation tool or in anatomically complex cases where ultrasound imaging is limited. The findings support the preferential use of ultrasound as the first-line imaging modality for regional anesthesia in a variety of clinical contexts. This review highlights the clinical and procedural advantages of ultrasound over CT and emphasizes the need for ongoing research to refine imaging-guided anesthetic techniques.
本系统评价评估了超声与计算机断层扫描（CT）在引导区域麻醉方面的相对有效性，重点关注阻滞准确性、麻醉扩散、临床疗效和操作安全性。共纳入了7项高质量临床研究，涵盖了一系列神经阻滞，如腹腔神经丛阻滞、肌间沟阻滞、横突间阻滞和竖脊肌平面阻滞。在麻醉分布、疼痛控制和患者满意度方面，超声引导始终显示出与CT引导相当或更优的结果。在大多数情况下，超声能够实现实时可视化，将操作并发症降至最低，并消除辐射暴露，同时保持高度准确性，这在部分试验中已通过CT或MRI得到验证。CT主要作为二级验证工具或在超声成像受限的解剖复杂病例中仍具有价值。这些发现支持在各种临床情况下优先使用超声作为区域麻醉的一线成像方式。本综述强调了超声相对于CT的临床和操作优势，并强调需要持续开展研究以完善成像引导麻醉技术。
