Efficacy and Safety of Ultrasound-Guided Nerve Block Versus Local Anesthesia for Arteriovenous Fistula Angioplasty: A Systematic Review and Meta-Analysis.
Ultrasound-guided nerve block linked to markedly less intra-procedural pain than local anesthesia
Efficacy and Safety of Ultrasound-Guided Nerve Block Versus Local Anesthesia for Arteriovenous Fistula Angioplasty: A Systematic Review and Meta-Analysis.
Severe intra-procedural pain commonly complicates percutaneous transluminal angioplasty (percutaneous transluminal angioplasty) for dysfunctional arteriovenous fistulas (arteriovenous fistulas), undermining patient cooperation and potentially increasing the need for sedative medications.
This systematic review and meta-analysis aimed to evaluate the analgesic efficacy, safety, and clinical performance of ultrasound-guided nerve block (ultrasound-guided nerve block) versus local anesthesia (local anesthesia) in adult patients undergoing arteriovenous fistulas percutaneous transluminal angioplasty.
We searched PubMed, Embase, Scopus, the Cochrane Library, and Web of Science for eligible randomized controlled trials and cohort studies published up to September 1, 2025.
nerve block cut pain far more than local anesthesia during the procedure
Subgroup analysis by block type showed a significant analgesic effect for BPB, whereas the SCNB subgroup had a wide confidence interval and very high heterogeneity; no significant between-subgroup difference was detected.
The pooled log risk ratio for the complication-free outcome was -0.02 (95% CI -0.05 to 0.02; p = 0.27), indicating no clinically meaningful difference in overall safety between groups.
No major nerve injury, pneumothorax, or persistent motor deficits were reported.
Ultrasound-guided nerve block was associated with superior analgesia without a clear increase in adverse events during arteriovenous fistulas percutaneous transluminal angioplasty.
Current evidence does not establish a statistically significant difference between BPB and SCNB, and the SCNB subgroup should be interpreted cautiously because of substantial heterogeneity.
Larger multicenter trials are needed to compare block techniques directly and to evaluate recovery, patency, and cost-effectiveness.