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

Abstract

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.