Cardiothoracic & vascular anesthesia
Analgesic efficacy and safety of erector spinae plane block after sternotomy and minimally invasive cardiac surgery: A systematic review and Meta-analysis of randomized trials
Pooled result · 24-h pain (0-10 VAS/NRS), median sternotomy subgroup (n = 1092)Result — go to the resultMD −0.65 95% CI - 1.14 to −0.16Authors' conclusion
Low- to very-low-certainty evidence suggests that ESPB is associated with modest improvements in early pain and recovery after median sternotomy; however, very high heterogeneity and wide prediction intervals indicate that effects may vary substantially between centers. In contrast, no clear benefit was demonstrated within ERAS-optimized MICS pathways, and findings in this subgroup remain preliminary.
Study context
- Population
- Adults undergoing cardiac surgery (median sternotomy or MICS)
- Participants
- 1,344 adults · 19 randomized controlled trials (RCTs)
- Comparison
- Ultrasound-guided erector spinae plane block (ESPB) vs standard systemic analgesia
- ESPBn = 673
- Outcome
- Postoperative pain
- Follow-up
- Within 24 h
Methodological detailsrandom-effects meta-analysis with Hartung-Knapp adjustment, stratified by surgical approach, RoB 2, GRADE
- Random-effects meta-analysis with Hartung-Knapp adjustment
- Stratified by surgical approach
- RoB 2
- GRADE
Pooled result
As reported in the abstract
24-h pain (0-10 VAS/NRS), median sternotomy subgroup (n = 1092) · 24 h
MD
−0.65
95% CI - 1.14 to −0.16
Further pooled results
| Outcome | Estimate |
|---|---|
| Intraoperative opioid consumption, median sternotomy subgroup | MD - 80.8 mg OME |
| 24-h opioid consumption, median sternotomy subgroup | MD - 45.8 mg OME |
| Time to extubation, median sternotomy subgroup | MD −1.28 h |
| ICU stay, median sternotomy subgroup | MD −13.1 h |
Opioid use and recovery outcomes, MICS subgroup (4 RCTs, n = 252)
- No clear statistically significant or clinically meaningful benefits for most outcomes
Original publication
Analgesic efficacy and safety of erector spinae plane block after sternotomy and minimally invasive cardiac surgery: A systematic review and Meta-analysis of randomized trials. J Clin Anesth. Published 30 May 2026. doi:10.
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