A Meta-Analysis of Ultrasound Guided Nerve Blocks for Enhanced Recovery in Adult Cardiac Surgery Patients

Abstract

Background: Ultrasound-guided nerve blocks can both reduce intraoperative opioid use and pain scores. However, its role in enhancing postoperative recovery for adult cardiac patients requires further investigation. This study examines the impact of ultrasound-guided nerve block on adult cardiac patients' recovery. Methods: We conducted a systematic search for randomized controlled trials (RCTs) published between 2018 to 2022, focusing ultrasound-guided nerve block in adult cardiac surgery. The search included Pubmed, Embase, and Cochrane databases, targeting studies on elective thoracotomy. The outcomes analyzed included postoperative extubation time, intensive care unit (ICU) stay time, and length of hospital stay (LOS), using Review Manager software (Review Manager 5.4, The Cochrane Collaboration, 2020, Beijing, China) for data synthesis and analysis. Results: Out of 26 RCTs, eight studies involving including 424 subjects were included in this meta-analysis. The results showed that ultrasound-guided nerve block significantly reduced postoperative extubation time (odds ratio [OR] = –2.16, 95% confidence interval [CI]: –3.05 to –1.26), ICU stay (OR = –1.17, 95% CI: –1.40 to –0.94), and overall hospitalization duration (OR = –0.96, 95% CI: –1.64 to –0.29). Conclusion: Ultrasound-guided nerve block significantly reduces the postoperative extubation time, ICU stay, and LOS, in adult cardiovascular surgery. These benefits contribute substantially to enhanced recovery after cardiac procedures. Registration: PROSPERO (CRD42023470545).