Advances in Ultrasound-Guided Fascial Plane Blocks for Perioperative Acute Pain Management.

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Abstract

Perioperative acute pain remains a major challenge because conventional analgesic strategies are often limited by inadequate efficacy and opioid-related adverse effects. Ultrasound-guided fascial plane blocks (FPBs) have become important components of multimodal analgesia. This review summarizes the mechanisms, clinical efficacy, safety, and future directions of major FPBs, including transversus abdominis plane, quadratus lumborum, and serratus anterior plane blocks, and discusses the emerging role of artificial intelligence (AI). PubMed, Embase, and the Cochrane Library were searched for relevant studies published up to December 2023. Clinical trials, meta-analyses, and mechanistic studies were reviewed, with emphasis on analgesic efficacy, opioid-sparing effects, safety, and AI-assisted applications. Current evidence indicates that ultrasound-guided FPBs provide effective truncal analgesia, reduce postoperative pain and opioid consumption, and may improve recovery while maintaining favorable safety profiles in selected settings. However, clinical benefits vary according to block type, surgical procedure, and comparator regimen. Adjuvants and continuous catheter techniques may prolong analgesia, whereas AI-assisted systems show promise for image interpretation and training. Ultrasound-guided FPBs are valuable components of perioperative multimodal analgesia and may improve analgesic quality while reducing opioid requirements.

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