The effect of ultrasound-guided erector spinae plane block on postsurgical pain: a meta-analysis of randomized controlled trials.

BACKGROUND

The effect of erector spinae plane block has been evaluated by clinical trials leading to a diversity of results. The main objective of the current investigation is to compare the analgesic efficacy of erector spinae plane block to no block intervention in patients undergoing surgical procedures.

METHODS

We performed a quantitative systematic review of randomized controlled trials in PubMed, Embase, Cochrane Library, and Google Scholar electronic databases from their inception through July 2019. Included trials reported either on opioid consumption or pain scores as postoperative pain outcomes. Methodological quality of included studies was evaluated using Cochrane Collaboration's tool.

RESULTS

Thirteen randomized controlled trials evaluating 679 patients across different surgical procedures were included. The aggregated effect of erector spinae plane block on postoperative opioid consumption revealed a significant effect, weighted mean difference of - 8.84 (95% CI: - 12.54 to - 5.14), (P < 0.001) IV mg morphine equivalents. The effect of erector spinae plane block on post surgical pain at 6 h compared to control revealed a significant effect weighted mean difference of - 1.31 (95% CI: - 2.40 to - 0.23), P < 0.02. At 12 h, the weighted mean difference was of - 0.46 (95% CI: - 1.01 to 0.09), P = 0.10. No block related complications were reported.

CONCLUSIONS

Our results provide moderate quality evidence that erector spinae plane block is an effective strategy to improve postsurgical analgesia.