REVIEW article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1574711
Efficacy evaluation of neuromuscular blocking agents as adjuncts to intravenous regional anesthesia: a meta-analysis of randomized controlled trials
Provisionally accepted
- 1Department of Anesthesiology, the First People's Hospital of Jiangxia District, Wuhan, Hebei Province, China
- 2Huazhong University of Science and Technology, Wuhan, China
- 3Xiangyang Central Hospital, Xiangyang, China
- 4Zhejiang Hospital, Hangzhou, Zhejiang Province, China
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Purpose: To evaluate the efficacy of neuromuscular blocking agents (NMBAs) as adjuncts to intravenous regional anesthesia (IVRA).Methods: Two researchers independently searched PUBMED, EMBASE, the Cochrane Library databases, and CBM for randomized controlled trials assessing the efficacy of NMBAs as adjuvants in IVRA.Results: This meta-analysis included 420 patients from 7 randomized controlled trials. Compared to IVRA using local anesthetics alone, the adjunctive use of NMBAs significantly shortened the onset time of sensory block (mean difference [MD] = -1.39 minutes, 95% confidence interval [CI]: -2.02 to -0.76; P < 0.01) and motor block (MD = -2.26 minutes, 95% CI: -4.23 to -0.29; P = 0.02). Moreover, NMBAs prolonged the duration of motor block (MD = 6.97 minutes, 95% CI: 0.06 to 13.88; P = 0.05). However, no significant improvement was observed in the duration of pain relief (MD = 1.21 minutes, 95% CI: -2.42 to 4.84; P = 0.51).Conclusion: As adjuncts to IVRA, NMBAs significantly reduce the onset time of sensory and motor blocks compared to local anesthetics alone. Additionally, NMBAs prolong the duration of motor block. These agents enhance the efficacy of IVRA by optimizing neuromuscular blockade while maintaining anesthetic quality comparable to standard IVRA techniques.
Keywords: Neuromuscular Blocking Agents, Intravenous regional anesthesia, Meta-analysis, randomized controlled trial, Adjuncts
Received: 11 Feb 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 Yang, Sun, Song, Zhang and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Rui Chen, Huazhong University of Science and Technology, Wuhan, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.