The Analgesic Efficacy of Erector Spinae Plane Blocks in Patients Undergoing Posterior Lumbar Spinal Surgery for Lumbar Fracture

Yu, Yulong; Wang, Mingcang; Hui, Ying; Ding, Jinfeng; Wang, Hongzhu; Wang, Yu

doi:10.1016/j.wneu.2020.10.175

Cited by 23 publications

(45 citation statements)

References 19 publications

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“…A total of 696 patients were enrolled in this systematic review and meta-analysis: 348 in the ESPB group (patients administered ESPB) and the remaining 348 in the control group (patients administered no block or a sham block). Eleven trials [ 13 - 16 , 18 - 24 ] reported the performance of ESPB before the surgery via ultrasound guidance and one trial [ 17 ] via intraoperative freehand administration. Four studies [ 15 , 16 , 20 , 23 ] confirmed the blocking effect of ESPB.…”

Section: Resultsmentioning

confidence: 99%

“…One study [ 24 ] performed sequential randomization via the order of surgery, which did not meet the allocation of randomization, and therefore was at high risk for risk of bias arising from the randomization process. Nine studies [ 13 , 15 - 18 , 21 - 24 ] did not describe whether the allocation sequence was concealed until the participants were enrolled and assigned to interventions, and thus these items created some concerns. Three studies [ 14 , 20 , 22 ] did not describe the details of their random sequence generation, so these studies created some concerns.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, these nine trials were at high risk for risk of bias. One trial [ 19 ] that performed sham blocks used subcutaneous infiltration (1 mL of 1% lidocaine) as a control, while two trials [ 17 , 18 ] that performed the sham block using saline were at low risk for risk of bias. Four trial [ 18 , 21 , 22 , 24 ] did not describe whether outcome assessors were aware of the intervention received by study participants, so the risk of bias in the measurement of the outcome (detection bias) was of some concerns.…”

Section: Resultsmentioning

confidence: 99%

“…Eight [ 13 - 15 , 17 - 20 , 23 ] and five [ 14 , 18 - 20 , 23 ] RCTs reported the 24- and 48-hour cumulative postoperative intravenous morphine equivalent consumption, respectively. Different types of opioids were converted into intravenous morphine doses.…”

Section: Resultsmentioning

confidence: 99%

“…It is worth noting that many of the studies included in the present analysis [ 13 - 16 , 20 - 24 ] were flawed in their implementation of blinding the participants to the noninterventional operation, as a control. Moreover, in some of the studies, the success of the block was not confirmed without validation of the block effect after its implementation [ 13 , 14 , 17 - 19 , 21 , 22 , 24 ], which may have confounded the results. It is difficult to implement blinding of the participants in this type of study of nerve blocks.…”

Section: Discussionmentioning

confidence: 99%

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Erector spinae plane block for spinal surgery: a systematic review and meta-analysis

2021

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Background Although the erector spinae plane block has been used in various truncal surgical procedures, its clinical benefits in patients undergoing spinal surgery remain controversial. The aim of this meta-analysis was to evaluate the clinical benefits of erector spinae plane block in patients undergoing spinal surgery. Methods We searched the Cochrane Library, PubMed, EMBASE, and China National Knowledge Infrastructure for randomized controlled trials comparing the erector spinae plane block with a nonblocked control for spinal surgery. Results Twelve studies encompassing 696 subjects were included in our systematic review and meta-analysis. We found that the erector spinae plane block decreased postoperative pain scores and opioid consumption in the postoperative and intraoperative periods. Moreover, it prolonged the time to the first rescue analgesic, reduced the number of patients who required rescue analgesia, and lowered the incidence of postoperative nausea and vomiting. However, it did not exhibit efficacy in decreasing the incidence of urinary retention and itching or shortening the length of hospital stays, or the time to first ambulation. Conclusions Erector spinae plane block improves analgesic efficacy among patients undergoing spinal surgery compared with nonblocked controls; however, there is insufficient evidence regarding the benefits of erector spinae plane block for rapid recovery.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Erector spinae plane block for spinal surgery: a systematic review and meta-analysis

2021

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Efficacy of erector spinae plane block on postoperative pain in patients undergoing lumbar spine surgery

et al. 2021

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Background Major lumbar spine surgery causes severe pain in the postoperative period. There are few studies regarding the effect of erector spinae plane block (ESPB) effect on lumbar surgery and its effect is still controversial. Therefore, the study aimed to investigate the effect of ultrasound-guided low thoracic ESPB on opioid consumption and postoperative pain score. Material and methods Seventy-eight patients undergoing elective open lumbar spine surgery were randomized into two groups. In ESPB group (n = 35) received ultrasound-guided ESPB and in the control group (n = 35), there was no block. Postoperative opioid consumption as morphine equivalent dose, numerical rating scale, mobilization time, discharge time and side effects, bolus deliveries, rescue analgesia doses were evaluated. Results Total opioid consumption as morphine equivalent was higher in the control group than the ESPB group (p = 0.000). Compare with the control group, the numeric rating scale scores were lower in the ESPB group at the 6th, 12th, and 24th hours (p < 0.05). The patient-controlled analgesia button pressing number in the postoperative 24-h period was lower in the ESPB group (p = 0.000). In the postoperative 24-h period, the need for paracetamol in the ESPB group was lower and the difference between the groups was statistically significant (p = 0.008). Rescue analgesia (diclofenac) doses were higher in the control group (p < 0.05). There was no statistically significant difference in terms of side effects and mobilization times. Conclusion ESPB is adequate for postoperative analgesia in patients undergoing lumbar spine surgery and can reduce opioid consumption compared with standard analgesia.

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Erector Spinae Plane Block on Postoperative Pain and Opioid Consumption After Lumbar Spine Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Wilson,

Schmid,

Pestaña

et al. 2024

Journal of PeriAnesthesia Nursing

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The Analgesic Efficacy of Erector Spinae Plane Blocks in Patients Undergoing Posterior Lumbar Spinal Surgery for Lumbar Fracture

Cited by 23 publications

References 19 publications

Erector spinae plane block for spinal surgery: a systematic review and meta-analysis

Erector spinae plane block for spinal surgery: a systematic review and meta-analysis

Efficacy of erector spinae plane block on postoperative pain in patients undergoing lumbar spine surgery

Erector Spinae Plane Block on Postoperative Pain and Opioid Consumption After Lumbar Spine Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials

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