Ultrasound-guided regional anesthesia (UGRA) in the emergency department: a scoping review

Introduction: While many studies have been published on Ultrasound-guided regional anesthesia in the Emergency Department (ED), there has been no previous study assessing the current state of the literature based in the form of a scoping review. Objective: The purpose of this study is to evaluate the current state of the literature on UGRA performed in the ED setting. Methods: EMBASE, MEDLINE, CINAHL, and Cochrane databases were searched for studies. Following PRISMA-ScR guidelines (Figure 1), two reviewers evaluated each title and abstract and were included if they described a UGRA technique performed on patients in the ED by an ED provider. Cohen’s kappa coefficients were calculated for each level of review. (Figure presented.) Results: Of the 1,456 abstracts, a total of 53 articles were included in the analysis, of which 28 (52.8%) were case series and 11 (20.8%) were randomized control trials (RCTs). The most common types of nerve block represented in these studies were femoral nerve/fascia iliaca (14), brachial plexus (7), and forearm (radial, ulnar, median nerves) (7). 47 of the 53 articles were published in or after the year 2010. Conclusion: Current literature supporting UGRA use in the ED is growing but unbalanced, requiring large population studies to demonstrate safety and efficacy of these techniques.