Cochrane · systematic review · CD011436
The use of ultrasound guidance for perioperative neuraxial and peripheral nerve blocks in children
Guay, J, Suresh, S, Kopp, S · Cochrane Database of Systematic Reviews · 2019 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
7
current version
GRADE rated
7
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 1 · 14.3%Low 1 · 14.3%Moderate 4 · 57.1%High 1 · 14.3%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyUltrasound guidance compared with no ultrasound guidance for children
Population: children (≤ 18 years of age) undergoing any type of surgical procedure (open or laparoscopic) for which a neuraxial (spinal, epidural, caudal, or combined spinal and epidural) or peripheral nerve block (any peripheral nerve block including fascial (fascia iliaca, transversus abdominis plane, rectus sheath blocks) or perivascular blocks) for surgical anaesthesia (alone or in combination with general anaesthesia) or for postoperative analgesia was performed with ultrasound guidance
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Failed blocks Ultrasound guidance vs no ultrasound guidance | no estimate extracted | 22 studies · 1789 participants | Moderate Downgraded: risk of bias |
Pain scores at 1 hour after surgery6 Ultrasound guidance vs no ultrasound guidance | no estimate extracted | 15 studies · 982 participants | Moderate Downgraded: risk of bias |
Block duration (0 to 1 day) Ultrasound guidance vs no ultrasound guidance | no estimate extracted | 10 studies · 460 participants | High |
Time to perform the block Ultrasound guidance vs no ultrasound guidance | no estimate extracted | 9 studies · 680 participants | Moderate Downgraded: risk of bias |
Number of needle passes Ultrasound guidance vs no ultrasound guidance | no estimate extracted | 3 studies · 256 participants | Very low Downgraded: risk of bias, imprecision, publication bias |
Minor complications Ultrasound guidance vs no ultrasound guidance | no estimate extracted | 13 studies · 896 participants | Low Downgraded: imprecision, publication bias |
Major complications Ultrasound guidance vs no ultrasound guidance | RD 0 | 22 studies · 1576 participants | Moderate Downgraded: imprecision |
Ultrasound guidance compared with no ultrasound guidance for children
Population: children
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Success (analysed as decreased failure rate) Ultrasound guidance vs no ultrasound guidance | no estimate extracted | 8 studies · 507 participants | High |
Pain scores at 1 hour after surgery Ultrasound guidance vs no ultrasound guidance | no estimate extracted | 7 studies · 308 participants | High |
Block duration Time to request of first analgesic Ultrasound guidance vs no ultrasound guidance | no estimate extracted | 8 studies · 358 participants | High |
Time to perform the procedure Ultrasound guidance used as pre‐scanning before neuraxial block Ultrasound guidance vs no ultrasound guidance | no estimate extracted | 2 studies · 122 participants | High |
Number of needle passes Ultrasound guidance vs no ultrasound guidance | no estimate extracted | 2 studies · 122 participants | High |
Bloody puncture Ultrasound guidance vs no ultrasound guidance | no estimate extracted | 2 studies · 204 participants | Low Downgraded: risk of bias, imprecision, indirectness, publication bias |