Effects of erector spinae plane block on postoperative pain and side-effects in adult patients underwent surgery: A systematic review and meta-analysis of randomized controlled trials

Cai, Qiang; Liu, Guoqing; Huang, Lei; Yang, Zixuan; Gao, Meiling; Ren, Jing; Liu, Zhen; Pan, Linghui

doi:10.1016/j.ijsu.2020.05.038

Cited by 44 publications

(33 citation statements)

References 31 publications

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“…The important finding of the current report is that ESPB reduced postoperative opioid consumption. This concurs well with the results of previous meta-analyses [ 6 , 7 , 26 ]. Opioid has long been used as a means to manage acute postoperative and postprocedural pain; however, a recent study reviewing clinical and administrative data from 135,379 adult patients receiving opioids after hospital-based surgeries or endoscopic procedures reported that 10.6% of the patients experienced opioid-related adverse events, which were related to poor outcomes, including increased inpatient mortality, prolonged length of hospital stay, and higher 30-day readmission rates [ 27 ].…”

Section: Discussionsupporting

confidence: 93%

The Effects of Erector Spinae Plane Block in Terms of Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy: A Meta-Analysis of Randomized Controlled Trials

Koo

Hwang

Shin

et al. 2020

JCM

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Ultrasound-guided erector spinae plane block (ESPB), a recent regional analgesic technique, has been used to manage acute pain after surgery. The aim of this meta-analysis is to identify the benefits of ESPB in patients undergoing laparoscopic cholecystectomy (LC). The authors searched PubMed, EMBASE, CENTRAL, CINAHL, and Web of Science to identify all randomized controlled trials (RCTs) evaluating the effects of ESPB on postoperative pain after LC. Primary outcome was defined as 24 h cumulative opioid consumption. Secondary outcomes were pain scores and the incidence of postoperative nausea and vomiting (PONV). We estimated mean differences (MD) and odds ratio (OR) using a random-effects model. A total of 8 RCTs, including 442 patients, were included in the final analysis. Postoperative opioid consumption was significantly lower in the ESPB group than in the control group (MD −4.72, 95% CI −6.00 to −3.44, p < 0.001). Compared with the control group, the ESPB group also showed significantly lower pain scores and incidence of PONV. A separate analysis of RCTs comparing ESPB with oblique subcostal transversus abdominis plane (OSTAP) block showed that the analgesic efficacy of ESPB was similar to that of OSTAP block. The results of this meta-analysis demonstrated that ESPB may provide effective postoperative analgesia in patients undergoing LC.

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Section: Discussionsupporting

confidence: 93%

The Effects of Erector Spinae Plane Block in Terms of Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy: A Meta-Analysis of Randomized Controlled Trials

Koo

Hwang

Shin

et al. 2020

JCM

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“…PONV was the most reported adverse event in the included studies. Our meta‐analysis showed that the incidence of PONV was significantly lower in the ESPB group than in the no‐block group, which was consistent with Cai 28 and Huang's 31 studies. Despite the complicated mechanism of PONV, 32 opioid may be the leading factor 33 .…”

Section: Discussionsupporting

confidence: 89%

“…The postoperative pain score was lower at 0 and 6 h after surgery in the ESPB group than in the no-block group, while the pain score did not show any differences between the two groups at postoperative 12 and 24 h. This implied that the duration of single-injection ESPB was less than 12 h. This result was consistent with that observed by Singh et al 26 They demonstrated that the average duration of analgesia provided by bilateral single-injection ESPB was between 6 and 8 h. Notably, the SMDs of the postoperative pain scores were small and the average pain score reduction in most of our included trials was below 1.3, which was not a clinically important difference (based on a minimal clinically important difference of 1.3). 27 However, Cai et al 28 demonstrated that ESPB could reduce postoperative pain clinically in adults. Nearly all our included trials [19][20][21][22][23]25 used a postoperative background analgesia strategy to facilitate pediatric postoperative pain management which might explain this discrepant finding.…”

Section: Discussionmentioning

confidence: 99%

Effects of erector spinae plane block on postoperative pain in children undergoing surgery: A systematic review and meta‐analysis of randomized controlled trials

Luo

Tong

Yan

et al. 2021

Pediatric Anesthesia

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Background:The erector spinae plane block is a novel regional anesthetic technique that is gaining popularity in pediatrics. However, the efficacy of erector spinae plane block in children is unclear. The aim of the systematic review and meta-analysis was to investigate effects of erector spinae plane block on postoperative pain relief in children.Methods: We searched MEDLINE, Cochrane Library, EMBASE, China National Knowledge Infrastructure, and Wan fang databases for randomized controlled trials that compared erector spinae plane block with no block or other types of block in pediatric patients undergoing surgeries. The primary outcomes were pain intensity at rest within 24 h postoperatively and the number of patients requiring rescue analgesics. Data were analyzed using the fixed-or random-effects model, depending on whether the heterogeneity tested by the I 2 statistic was >30%. We assessed the quality of evidence for the outcomes using the Grading of Recommendations, Assessment, Development, and Evaluation method.Results: Seven randomized controlled trials involving 379 patients were reviewed.

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“…Huang W [33] found that ESPB resulted in equivalent analgesic efficacy to TPVB without an increased incidence of PONV and was a suitable alternative choice to TPVB. Another meta-analysis [36] found that postoperative pain scores in patients who received ESPB were lower than those in the control group at rest or at movement, regardless of whether they had thoracic or spinal and abdominal surgery. Researchers also proved that ESPB reduced PONV and provided comfortable experience with patients.…”

Section: Discussionmentioning

confidence: 99%

The analgesic effect of erector spinae plane block in thoracic surgery: a systematic review and meta-analysis of randomized controlled trials

Li¹,

Hou²,

Guan³

et al. 2021

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Objectives: The aim of this study is to evaluate the analgesic effect of erector spinae plane block (ESPB) in patients undergoing thoracic surgery. Methods: We systematically searched Embase, PubMed, The Cochrane Library, VIP database, CNKI, Wanfang database, CBM, from 2010 to December, 2020 to perform a meta-analysis of randomized controlled trials (RCTs) on the analgesic effect of ESPB in thoracic surgery patients. The primary outcome were postoperative pain scores at various time points. Results: Eighteen studies with a total of 1303 patients were included. The meta-analysis found that ESPB reduced postoperative 48-hour pain scores at rest or movement at different time points compared with the control group, reduced the incidence of postoperative nausea and vomiting (PONV) (odds ratio, OR = 0.48, 95% CI = 0.33∼0.71, P < 0.05), and reduced the number of patient-controlled intravenous analgesia (PCIA) pressing times (mean difference, MD = −6.83, 95% CI = −8.73∼−4.94, P < 0.05). Conclusions: Compared with general anesthesia (GA), GA combined with ESPB significantly decreases postoperative pain, PONV and opioids requirements following thoracic surgery.

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Effects of erector spinae plane block on postoperative pain and side-effects in adult patients underwent surgery: A systematic review and meta-analysis of randomized controlled trials

Cited by 44 publications

References 31 publications

The Effects of Erector Spinae Plane Block in Terms of Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy: A Meta-Analysis of Randomized Controlled Trials

The Effects of Erector Spinae Plane Block in Terms of Postoperative Analgesia in Patients Undergoing Laparoscopic Cholecystectomy: A Meta-Analysis of Randomized Controlled Trials

Effects of erector spinae plane block on postoperative pain in children undergoing surgery: A systematic review and meta‐analysis of randomized controlled trials

The analgesic effect of erector spinae plane block in thoracic surgery: a systematic review and meta-analysis of randomized controlled trials

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