Journal of Pain Research (Mar 2022)

The Effect of Single-Shot Erector Spinae Plane Block (ESPB) on Opioid Consumption for Various Surgeries: A Meta-Analysis of Randomized Controlled Trials

  • Cui Y,
  • Wang Y,
  • Yang J,
  • Ran L,
  • Zhang Q,
  • Huang Q,
  • Gong T,
  • Cao R,
  • Yang X

Journal volume & issue
Vol. Volume 15
pp. 683 – 699

Abstract

Read online

Yu Cui,1,* Yu Wang,2,* Jing Yang,1,* Longqing Ran,1,* Qianqian Zhang,1 Qinghua Huang,1 Tianqing Gong,1 Rong Cao,1 Xiao Yang3 1Department of Anesthesiology, The Affiliated Hospital, School of Medicine, UESTC Chengdu Women’s & Children’s Central Hospital, Chengdu, People’s Republic of China; 2Department of Anesthesiology, No.363 Hospital, Chengdu, People’s Republic of China; 3Department of Hospital Management, The Affiliated Hospital, School of Medicine, UESTC Chengdu Women’s & Children’s Central Hospital, Chengdu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiao Yang, Tel/Fax +86 13882288881, Email [email protected] Objective: Pain management plays a pivotal role in enhanced recovery after surgery (ERAS). Erector spinae plane block (ESPB) is widely used in many regions to treat perioperative pain, but its benefits are still somewhat controversial. We, therefore, intent to systematically review the available literature on ESPB, to elucidate its effects on opioid-sparing analgesia, and summarize its potential complications.Design: Systematic review of randomized controlled trials (RCTs) with meta-analysis.Setting: Postoperative opioid consumption for various surgeries.Patients: Patients undergoing various surgeries.Intervention: We searched relevant studies in PubMed, EMBASE, Medline, and the Cochrane Library up to May 16, 2021. All prospective and RCTs that compared ESPB and sham block or no block were enrolled.Measurements: The primary outcomes were postoperative opioid consumption during the first 24 hours. The secondary outcomes were the requirement of rescue analgesia, time to first rescue analgesic and ESPB-related adverse events.Results: We included 52 trials that reported postoperative opioid consumption during the first 24 hours. The results presented that compared to control group (ie, no intervention or a sham block), ESPB reduced the accumulated opioid consumption during the first 24 h after surgery [mean difference (MD) of − 12.83 (95% CI: − 17.29 to − 8.38; p < 0.001) mg; I2 = 100%]. Besides, ESPB could prolong time to first rescue analgesia after surgery [SMD = 5.31; 95% CI 4.01– 6.61; p < 0.001; I2 = 97%]. The number of patients who received rescue analgesia after surgery in the ESPB group was less than that in the control group (OR 0.13; 95% CI 0.09, 0.21; p < 0.001; I2 = 54%), and the incidence of PONV was lower in the ESPB group (OR 0.51; 95% CI 0.43, 0.62; p < 0.001; I2 = 19%).Conclusion: ESPB is an effective technique on pain management with few complications.Keywords: erector spinae plane block, ESPB, opioid consumption, postoperative nausea and vomiting, PONV

Keywords