Evidence for the Use of Ultrasound Imaging in Pediatric Regional Anesthesia: A Systematic Review.

Abstract

An earlier review to evaluate the quality and outcomes of studies assessing ultrasound imaging in regional anesthesia for the pediatric population considered articles published from 1994 to 2009 and showed some evidence in support of block-related outcomes (block onset, success, duration) and process-related outcomes (performance time, local anesthetic dose, and spread). At that time, strong evidence in the form of randomized controlled trials and well-designed prospective observational studies was limited, leading to a call for additional research. The current systematic review (2009-2014) compares and updates the evidence for ultrasound-guided pediatric regional anesthesia published since our last review. Using the MEDLINE and EMBASE databases, we included in this review studies examining ultrasound imaging for nerve localization in the pediatric population between 2009 and March 2014 (meta-analyses, systematic reviews, randomized controlled trials, controlled studies without randomization, observational studies, comparative studies, and case series involving at least 10 patients). In the current review, we identified 24 and 13 articles evaluating peripheral nerve blocks and neuraxial anesthesia, respectively.