Comparing Ultrasound and Computed Tomography in Regional Anesthesia: Real-Time Precision or Radiologic Clarity?

This systematic review evaluates the comparative effectiveness of ultrasound and computed tomography (CT) in guiding regional anesthesia, with a focus on block accuracy, anesthetic spread, clinical efficacy, and procedural safety. A total of seven high-quality clinical studies were included, encompassing a range of nerve blocks such as celiac plexus, interscalene, intertransverse, and erector spinae plane blocks. Ultrasound guidance consistently demonstrated outcomes that were equivalent or superior to CT guidance in terms of anesthetic distribution, pain control, and patient satisfaction. In most cases, ultrasound enabled real-time visualization, minimized procedural complications, and eliminated radiation exposure while maintaining a high degree of accuracy, as validated by CT or MRI in select trials. CT retained value primarily as a secondary validation tool or in anatomically complex cases where ultrasound imaging is limited. The findings support the preferential use of ultrasound as the first-line imaging modality for regional anesthesia in a variety of clinical contexts. This review highlights the clinical and procedural advantages of ultrasound over CT and emphasizes the need for ongoing research to refine imaging-guided anesthetic techniques.