Systematic review and meta-analysis of the effect of nerve block under ultrasound in ilioinguinal/iliohypogastric in children

Abstract

Background: Ilioinguinal/iliohypogastric nerve block (IINB) is a common operation in pediatric surgery. Nerve block under contrast-enhanced ultrasound (CEUS) has the advantages of visualization and noninvasiveness, which creates conditions for its application in nerve block. It can significantly improve the success rate of nerve block and reduce the complications of nerve block. At present, few studies in China have analyzed the effect of nerve block guided by ultrasound technology compared with ordinary treatment. Methods: With “ilioinguinal/iliohypogastric nerve block”, “ultrasonic examination of the children”, and “ultrasonography for ilioinguinal/iliohypogastric” as the keywords, the related literature published before 2022 was searched. RevMan 5.3 and Stata provided by the Cochrane Collaboration were employed for analysis and evaluation. Begg’s risk of bias was utilized to assess the risk bias of the included references. Heterogeneity among studies was evaluated using the Q test and heterogeneity (I2). Results: Six studies were included, with a total of 391 cases. The overall risk (OR) of ilioinguinal/ iliosubabdominal complications in children treated with nerve block after ultrasound examination was 0.49, and the complications of ilioventral/iliosubabdominal complications in children treated with nerve block after ultrasound examination were reduced. The OR of inhibiting pain events was 0.35, and the ilioinguinal/ iliosubabdominal pain events were reduced after nerve block treatment by ultrasound examination. The OR of inhibiting adverse reactions was 0.45. After ultrasound examination, the adverse reactions of ilioinguinal/ iliosubabdominal nerve block treatment were reduced, and there was no heterogeneity among the study groups (I2=0.00%). Conclusions: The results of the meta-analysis confirmed that the complications of nerve block treatment after ultrasound examination were less than those of ordinary treatment. The incidence of pain events and adverse reactions in nerve block treatment were reduced after ultrasonography. Moreover, in terms of pain events, the effect of ultrasound guidance was significant. In short, in clinical studies, CEUS can be used to accurately evaluate complex situations and provide a more accurate reference for subsequent treatment.