Emergency physician-performed ultrasound-guided nerve blocks: A scoping review of the published literature

Ultrasound-guided nerve blocks (UGNBs) continue to grow within the practice of emergency medicine. The purpose of this scoping review was to summarize the existing literature reporting UGNBs performed by emergency physicians (EPs) to identify trends in the literature and directions for future research.

Utilizing PRISMA-ScR guidelines, we electronically searched the PubMed, Scopus, Embase, and Cochrane libraries from database inception to May 12, 2025, to identify clinical studies reporting on outcomes of EP-performed UGNBs. Records were screened in duplicate, and data was extracted from each included article for quantitative and qualitative synthesis, adhering to best practice guidelines.

From an initial database search of 4821 records, 238 articles were included consisting of 9055 individual UGNB encounters. There were 34 randomized clinical trials (14 %) and 30 non-randomized prospective studies (13 %), while the rest (73 %) were retrospective studies and case reports. The first report on EP-performed UGNB was published in 2003, and nearly two-thirds of included articles were published since 2020. Overall, 52 different types of UGNBs have been performed by EPs. Lower extremity blocks were most frequently reported (97 articles, 41 %). Publications of truncal blocks (77 articles, 30 %), especially the erector spinae plane block (43 articles, 18 %), have seen a rapid increase over the past 5 years. Complications occurred in 0.89 % of blocks, including three cases (0.03 %) of local anesthetic systemic toxicity.

Published reports of EP-performed UGNBs continue to increase, with many UGNB techniques having been performed for the first time for novel indications in the ED. This scoping review summarized the existing published literature on EP-performed UGNBs to map the current scope of practice and highlight areas for future research.