Effectiveness of ultrasound-guided regional anesthesia for pain reduction in the Emergency Department of a Tertiary Care Centre: An observational study

Background: Pain is the most common presentation in the Emergency Department (ED), yet its management is often suboptimal due to a busy environment, leading to oligoanalgesia. Traditional blind landmark-based nerve blocks and procedural sedation have notable disadvantages. Ultrasound-guided regional anesthesia (UGRA) offers a safe and effective alternative, addressing the complications of conventional methods. Methodology: This prospective observational study was conducted at the ED of a tertiary care center from October 2022 to March 2024. Patients meeting the inclusion and exclusion criteria were enrolled after informed consent. Pain scores were recorded before and after the procedure. Pain relief was considered successful if there was at least a two-point reduction in pain score 30 minutes after the procedure. If the patient experienced discomfort during the procedure, it was considered an inadequate block, and additional analgesia was administered. If there was no pain reduction within 20 minutes, the block was deemed a failure. Results: A total of 101 UGRA procedures were performed. Overall, 94.1% of patients had successful blocks, while 5.9% experienced block failure. The mean pain score at baseline was 7.4, which significantly dropped to 1.4 after 30 minutes of UGRA. Physicians reported high satisfaction with the ease of procedure, anatomical visibility, and local anesthetic spread. Conclusion: The study demonstrates that UGRA is a highly effective and safe technique for pain management in the ED, with a high success rate and minimal complications when performed by emergency physicians.