Comparative efficacy of ultrasound guidance or conventional anatomical landmarks for neuraxial puncture in adult patients: a systematic review and network meta-analysis
Authors' conclusion
This NMA provides evidence supporting ultrasound-guided neuraxial puncture compared with use of anatomical landmarks, including indirect comparisons. Among the three ultrasound guidance methods, preprocedural ultrasound appears to be a better adjunctive option.
Study context
- Population
- Adults undergoing neuraxial puncture
- Participants
- 7,090 adults · 74 studies
- Comparison
- Preprocedural, real-time or computer-aided 3D ultrasound guidance vs anatomical landmarks for neuraxial puncture
- Outcome
- First-pass success and patient satisfaction
Methodological detailsrandom-effects network meta-analysis
- Random-effects network meta-analysis
Pooled result
As reported in the abstract
First-pass success; patient satisfaction (co-primary)
Each group vs anatomical landmarksRR for first-pass success (95% CrI)
Preprocedural USCrI; moderate confidence
1.6(1.3–1.9)
Real-time USCrI; moderate confidence
1.9(1.3–2.9)
- Preprocedural US · CrI; low confidence
- SMD for patient satisfaction 0.28 (95% CrI 0.092–0.47)
Further pooled results
| Outcome | SMD (95% CrI) | |
|---|---|---|
| Patient satisfaction (co-primary)Preprocedural ultrasound vs Anatomical landmarks · CrI; low confidence | 0.28 (0.092–0.47) | |
| −0.200.20.40.6Difference (linear scale) |
- Patient satisfaction (co-primary): 95% CrI
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Comparative efficacy of ultrasound guidance or conventional anatomical landmarks for neuraxial puncture in adult patients: a systematic review and network meta-analysis. Br J Anaesth. Published 6 October 2023. doi:10.
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