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, Chang Hoon; Hwang, Jin Young; Shin, Hyung-Jin; Ryu, Jin Suk

doi:10.3390/jcm9092928

Cited by 21 publications

(9 citation statements)

References 34 publications

(65 reference statements)

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“…A previous meta-analysis by Daghmouri et al reported no significant difference between the ESPB and control groups, but only included five RCTs [46]. Our meta-analysis found that ESPB can reduce the incidence of PON and POV after surgery, which is consistent with the results of Koo's study [38]. Regional blocks such as ESPB, as mentioned above, possibly reduce the incidence of nausea and vomiting by reducing opioid consumption.…”

Section: Discussionsupporting

confidence: 88%

“…ESPB is a relatively novel regional block, and although the mechanism is still controversial, many clinical trials have confirmed its effectiveness in pain control and is being quickly applied as a part of multimodal postoperative analgesia. A previous meta-analysis by Koo et al revealed that the ESPB group had lower the pain scores at postoperative 12 h than the control group, but no significant difference was noted at 24 h [38]. In our updated analysis, ESPB reduced the pain score at postoperative 24 h. To our knowledge, this is the first meta-analysis to show the long-lasting analgesic effect of ESPB at 24 h in LC.…”

Section: Discussionsupporting

confidence: 44%

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Analgesic effect of erector spinae plane block in adults undergoing laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trials

Yang

Chen

et al. 2023

BMC Anesthesiol

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Background Laparoscopic cholecystectomy is the gold standard surgical procedure for treating gallstone disease. Despite it being minimally invasive, various medications and methods are used to alleviate postoperative pain, and some patients still experience moderate-to-severe pain. This is a crucial problem that must be solved to avoid chronic pain. As part of postoperative multimodal analgesia, regional block is being increasingly applied in surgery under ultrasound guidance. We aimed to evaluate the analgesic effect of erector spinae plane block in adult patients undergoing laparoscopic cholecystectomy. Methods PubMed, Cochrane Library, EMBASE, and Web of Science were searched for randomized controlled trials investigating the efficacy of erector spinae plane block on postoperative pain after laparoscopic cholecystectomy. The primary outcome was the postoperative pain score. The secondary outcomes were the cumulative intraoperative and postoperative opioid consumption at 24 h, incidence of postoperative nausea and vomiting, and shoulder pain after surgery. The results were pooled using the fixed- or random-effects model with Review Manager 5.3. Results Fifteen randomized controlled trials involving 947 patients were included in the analysis. Postoperative pain score in the erector spinae plane block group was lower than that in the control group at postoperative 12 h (MD − 0.81, 95% CI − 1.1 to − 0.51, p < 0.00001) and 24 h (MD − 0.41, 95% CI − 0.62 to − 0.19, p = 0.0002). Cumulative opioid consumption was lower in the erector spinae plane block group than in the control group at postoperative 24 h (MD − 7.88, 95% CI − 10.17 to − 5.58, p < 0.00001). The erector spinae plane block group also experienced a lower incidence of postoperative nausea and vomiting than the control group. Opioid consumption and the incidence of postoperative nausea and vomiting were similar between the erector spinae plane block group and other block groups, including the oblique subcostal transversus abdominis plane block and quadratus lumborum block groups. Conclusions Ultrasound-guided erector spinae plane block provides effective postoperative analgesia in adults undergoing laparoscopic cholecystectomy.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 44%

Analgesic effect of erector spinae plane block in adults undergoing laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trials

Yang

Chen

et al. 2023

BMC Anesthesiol

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“…Erector spinae plane block (ESPB) is a novel regional block technique, which was first described by Forero in 2016 as the injection of local anesthetic into the plane between the deep fascia of the erector spinae muscle and the vertebral transverse process under ultrasound guidance [3]. Over the last few years, ESPB has been demonstrated to be effective in various type of surgeries, including breast surgery [4], thoracic surgery [5], and laparoscopic cholecystectomy [6], among others. Several randomized controlled trials (RCTs) have reported that ESPB could be a factor influencing postoperative analgesia after lumbar spinal surgery [7,8]; however, no systematic and persuasive evidence has been presented.…”

Section: Introductionmentioning

confidence: 99%

Postoperative Analgesic Efficacy of Erector Spinae Plane Block in Patients Undergoing Lumbar Spinal Surgery: A Systematic Review and Meta-Analysis

et al. 2021

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Lumbar spine surgery is one of the most widespread types of surgery for treating back and leg pain. However, the postoperative period always presents with severe pain due to the removal of skin, subcutaneous tissues, bones, and ligaments. Patients usually require high doses of opioids to relieve pain during the initial three days after operation, as well as experience drugrelated complications and prolonged length of stay in hospital. We found that Erector spinae plane block significantly reduced postoperative opioid consumption and pain scores. The present systematic review revealed that ESPB was effective and safe for postoperative analgesia.

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“…Also, the block is relatively easier to perform and is done under the guidance of ultrasonography. Due to all its features, the use of ESPB is common in abdominal such as laparoscopic cholecystectomy, breast and thoracic surgery (12)(13)(14). The role of ESPB in spinal surgeries is being explored through recent randomized controlled trials (RCTs); however, the results are conflicting.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Erector Spinae Nerve Block for Pain Control After Spinal Surgeries: An Updated Systematic Review and Meta-Analysis

Duan¹,

Fu³

2022

Front. Surg.

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BackgroundErector spinae plane block (ESPB), as a regional anesthesia modality, is gaining interest and has been used in abdominal, thoracic and breast surgeries. The evidence on the efficacy of this block in spinal surgeries is equivocal. Recently published reviews on this issue have concerning limitations in methodology.MethodsA systematic search was conducted using the PubMed, Scopus, Embase, and Cochrane Central Register of Controlled Trials (CENTRAL). Randomized controlled trials (RCTs) that were done in patients undergoing spinal surgery and had compared outcomes of interest among those that received ESPB and those with no block/placebo were considered for inclusion. Statistical analysis was performed using STATA software. GRADE assessment was done for the quality of pooled evidence.ResultsA total of 13 studies were included. Patients receiving ESPB had significantly reduced total opioid use (Standardized mean difference, SMD −2.76, 95% CI: −3.69, −1.82), need for rescue analgesia (Relative risk, RR 0.38, 95% CI: 0.22, 0.66) and amount of rescue analgesia (SMD −5.08, 95% CI: −7.95, −2.21). Patients receiving ESPB reported comparatively lesser pain score at 1 h (WMD −1.62, 95% CI: −2.55, −0.69), 6 h (WMD −1.10, 95% CI: −1.45, −0.75), 12 h (WMD −0.78, 95% CI: −1.23, −0.32) and 24 h (WMD −0.54, 95% CI: −0.83, −0.25) post-operatively. The risk of postoperative nausea and vomiting (PONV) (RR 0.32, 95% CI: 0.19, 0.54) was lower in those receiving ESPB. There were no differences in the duration of surgery, intra-operative blood loss and length of hospital stay between the two groups. The quality of pooled findings was judged to be low to moderate.ConclusionsESPB may be effective in patients with spinal surgery in reducing post-operative pain as well as need for rescue analgesic and total opioid use. In view of the low to moderate quality of evidence, more trials are needed to confirm these findings.Systematic Review Registration:http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42021278133.

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

Cited by 21 publications

References 34 publications

Analgesic effect of erector spinae plane block in adults undergoing laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trials

Analgesic effect of erector spinae plane block in adults undergoing laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trials

Postoperative Analgesic Efficacy of Erector Spinae Plane Block in Patients Undergoing Lumbar Spinal Surgery: A Systematic Review and Meta-Analysis

Efficacy of Erector Spinae Nerve Block for Pain Control After Spinal Surgeries: An Updated Systematic Review and Meta-Analysis

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