Efficacy And Safety Of Brachial Plexus Block By Ultrasound Guidance Compared With Peripheral Nerve Stimulator:a Meta-analysis Of Randomized Controlled Trials

Objective: To evaluate the efficacy and safety of brachial plexus block by comparedwith peripheral nerve stimulator. Methods: We searched Ovid MEDLINE, the CochraneCentral Register of Controlled Trials, Embase, PubMed, CNKI, and CBM databases andalso the reference lists of relevant publications for eligible studies. A total of16studiesmet our criteria and were included for analysis. Studies were rated for methodologicalquality by two reviewers. Data from these studies were abstracted and synthesized usinga meta-analysis by Revman5.0software.Results: Sixteen trials involving1026adults metour criteria were included for analysis. Blocks performed using US guidance were morelikely to be successful (RR=0.41,95%Cl0.26~0.61,P<0.00001), decreased incidence ofvascular puncture during block performance （RR=0.12,95%Cl0.26~0.61,P<0.00001）,took less time to perform (WMD=-5.35,95%CI-5.71~-2.08,P<0.0001), and had fasteronset (WMD=-5.35,95%CI-8.04~-2.65,P<0.0001), than those performed with PNSguidance. Conclusion: US improves efficacy and safety of peripheral nerve blockcompared with techniques that utilize PNS for nerve localization. US decreases risks ofneurologic complications paresis or vascular puncture and improves success rate ofbrachial plexus nerve block.