1887
Volume 2026, Issue 1
  • ISSN: 1999-7086
  • E-ISSN: 1999-7094

Pain is the most common presentation in the Emergency Department (ED), yet its management is often suboptimal due to a busy environment, leading to oligoanalgesia. Traditional blind landmark-based nerve blocks and procedural sedation have notable disadvantages. Ultrasound-guided regional anesthesia (UGRA) offers a safe and effective alternative, addressing the complications of conventional methods.

This prospective observational study was conducted at the ED of a tertiary care center from October 2022 to March 2024. Patients meeting the inclusion and exclusion criteria were enrolled after informed consent. Pain scores were recorded before and after the procedure. Pain relief was considered successful if there was at least a two-point reduction in pain score 30 minutes after the procedure. If the patient experienced discomfort during the procedure, it was considered an inadequate block, and additional analgesia was administered. If there was no pain reduction within 20 minutes, the block was deemed a failure.

A total of 101 UGRA procedures were performed. Overall, 94.1% of patients had successful blocks, while 5.9% experienced block failure. The mean pain score at baseline was 7.4, which significantly dropped to 1.4 after 30 minutes of UGRA. Physicians reported high satisfaction with the ease of procedure, anatomical visibility, and local anesthetic spread.

The study demonstrates that UGRA is a highly effective and safe technique for pain management in the ED, with a high success rate and minimal complications when performed by emergency physicians.

Loading

جارٍ تحميل قياسات المقالة...

/content/journals/10.5339/jemtac.2026.2
٢٠٢٦-٠١-٢٢
٢٠٢٦-٠١-٢٨

القياسات

Loading full text...

Full text loading...

/deliver/fulltext/jemtac/2026/1/jemtac.2026.2.html?itemId=/content/journals/10.5339/jemtac.2026.2&mimeType=html&fmt=ahah

References

  1. Cordell WH, Keene KK, Giles BK, Jones JB, Jones JH, Brizendine EJ. The high prevalence of pain in emergency medical care. Am J Emerg Med. 2002 May; 20:(3):165–9. https://doi.org/10.1053/ajem.2002.32643
    [Google الباحث العلمي]
  2. Tucker RV, Peterson WJ, Mink JT, Taylor LA, Leech SJ, Nagdev AD, et al. Defining an ultrasound-guided regional anesthesia curriculum for emergency medicine. AEM Educ Train. 2020 Dec; 5:(3):e10557. https://doi.org/10.1002/aet2.10557
    [Google الباحث العلمي]
  3. Morrison RS, Dickman E, Hwang U, Akhtar S, Ferguson T, Huang J, et al. Regional nerve blocks improve pain and functional outcomes in hip fracture: a randomized controlled trial. J Am Geriatr Soc. 2016 Dec; 64:(12):2433–9. https://doi.org/10.1111/jgs.14386
    [Google الباحث العلمي]
  4. American College of Emergency Physicians. Ultrasound-guided nerve blocks. Accessed July 7, 2024. Available from: https://www.acep.org/patient-care/policy-statements/ultrasound-guided-nerve-blocks
    [Google الباحث العلمي]
  5. Malik A, Thom S, Haber B, Sarani N, Ottenhoff J, Jackson B, et al. Regional anesthesia in the emergency department: an overview of common nerve block techniques and recent literature. Curr Emerg Hosp Med Rep. 2022 Jul; 10:(3):54–66. https://doi.org/10.1007/s40138-022-00249-w
    [Google الباحث العلمي]
  6. Ketelaars R, Stollman JT, van Eeten E, Eikendal T, Bruhn J, van Geffen GJ. Emergency physician-performed ultrasound-guided nerve blocks in proximal femoral fractures provide safe and effective pain relief: a prospective observational study in the Netherlands. Int J Emerg Med. 2018 Mar; 11:(1):12. https://doi.org/10.1186/s12245-018-0173-z
    [Google الباحث العلمي]
  7. Farrar JT, Young JP, LaMoreaux L, Werth JL, Poole MR. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain. 2001 Nov; 94:(2):149–58. https://doi.org/10.1016/S0304-3959(01)00349-9
    [Google الباحث العلمي]
  8. Gadsden J, Warlick A. Regional anesthesia for the trauma patient: improving patient outcomes. Local Reg Anesth. 2015 Aug; 8:45–55. https://doi.org/10.2147/LRA.S55322
    [Google الباحث العلمي]
  9. Kuypers MI, Veldhuis LI, Mencl F, van Riel A, Thijssen WAHM, Tromp E, et al. Procedural sedation and analgesia versus nerve blocks for reduction of fractures and dislocations in the emergency department: a systematic review and meta-analysis. J Am Coll Emerg Physicians Open. 2023 Jan; 4:(1):e12886. https://doi.org/10.1002/emp2.12886
    [Google الباحث العلمي]
  10. Bhoi S, Sinha TP, Rodha M, Bhasin A, Ramchandani R, Galwankar S. Feasibility and safety of ultrasound-guided nerve block for management of limb injuries by emergency care physicians. J Emerg Trauma Shock. 2012 Jan; 5:(1):28–32. https://doi.org/10.4103/0974-2700.93107
    [Google الباحث العلمي]
  11. Stone MB, Wang R, Price DD. Ultrasound-guided supraclavicular brachial plexus nerve block vs procedural sedation for the treatment of upper extremity emergencies. Am J Emerg Med. 2008 Jul; 26:(6):706–10. https://doi.org/10.1016/j.ajem.2007.09.011
    [Google الباحث العلمي]
  12. Cogan CJ, Kandemir U. Role of peripheral nerve block in pain control for the management of acute traumatic orthopaedic injuries in the emergency department: diagnosis-based treatment guidelines. Injury. 2020 Jul; 51:(7):1422–5. https://doi.org/10.1016/j.injury.2020.04.016
    [Google الباحث العلمي]
  13. David S, Katumalla P, Ganesan P, Abhilash Kundavaram PP. One-man below-knee analgesia in the emergency department with minimal equipment using the single-operator nerve block under direct ultrasound visualization in emergency (‘SANDY’) technique: a retrospective analysis. Eurasian J Emerg Med. 2023 Mar; 22:(1):41–8. https://doi.org/10.4274/eajem.galenos.2022.37640
    [Google الباحث العلمي]
  14. Dochez E, van Geffen GJ, Bruhn J, Hoogerwerf N, van de Pas H, Scheffer G. Prehospital administered fascia iliaca compartment block by emergency medical service nurses, a feasibility study. Scand J Trauma Resusc Emerg Med. 2014 Jun; 22:38. https://doi.org/10.1186/1757-7241-22-38
    [Google الباحث العلمي]
  15. Gozlan C, Minville V, Asehnoune K, Raynal P, Zetlaoui P, Benhamou D. [Fascia iliaca block for femoral bone fractures in prehospital medicine.] Ann Fr Anesth Reanim. 2005 Jun; 24:(6):617–20. https://doi.org/10.1016/j.annfar.2005.03.030
    [Google الباحث العلمي]
  16. Zaki Hany A, Iftikhar H, Shallik N, Elmoheen A, Bashir K, Shaban EE, et al. An integrative comparative study between ultrasound-guided regional anesthesia versus parenteral opioids alone for analgesia in emergency department patients with hip fractures: a systematic review and meta-analysis. Heliyon. 2022 Dec; 8:(12):e12413. https://doi.org/10.1016/j.heliyon.2022.e12413
    [Google الباحث العلمي]
  17. Liebmann O, Price D, Mills C, Gardner R, Wang R, Wilson S, et al. Feasibility of forearm ultrasonography-guided nerve blocks of the radial, ulnar, and median nerves for hand procedures in the emergency department. Ann Emerg Med. 2006 Nov; 48:(5):558–62. https://doi.org/10.1016/j.annemergmed.2006.04.014
    [Google الباحث العلمي]
  18. Abrahams MS, Aziz MF, Fu RF, Horn JL. Ultrasound guidance compared with electrical neurostimulation for peripheral nerve block: a systematic review and meta-analysis of randomized controlled trials. Br J Anaesth. 2009 Mar; 102:(3):408–17. https://doi.org/10.1093/bja/aen384
    [Google الباحث العلمي]
  19. Shilpashri AM, Chikkanagoudar S. Comparison of landmark technique versus ultrasound guided technique for supraclavicular brachial plexus block in upper limb surgeries: a prospective randomized trial. Indian J Clin Anaesth. 2023; 10:(3):242–7. https://doi.org/10.18231/j.ijca.2023.051
    [Google الباحث العلمي]
  20. Weinberg L, Peake B, Tan C, Nikfarjam M. Pharmacokinetics and pharmacodynamics of lignocaine: a review. World J Anesthesiol. 2015 Jul; 4:(2):17–29. https://doi.org/:10.5313/wja.v4.i2.17
    [Google الباحث العلمي]
  21. Bailard NS, Ortiz J, Flores RA. Additives to local anesthetics for peripheral nerve blocks: evidence, limitations, and recommendations. Am J Health Syst Pharm. 2014 Mar; 71:(5):373–85. https://doi.org/10.2146/ajhp130336
    [Google الباحث العلمي]
/content/journals/10.5339/jemtac.2026.2
Loading
/content/journals/10.5339/jemtac.2026.2
Loading

جارٍ تحميل البيانات والوسائط...

الأكثر اقتباسًا لهذا الشهر Most Cited RSS feed

هذه الخانة مطلوبة
يُرجى إدخال عنوان بريد إلكتروني صالح
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error