Efficacy and safety of sacral erector spinae plane (S-ESP) block in adult and pediatric patients during surgical procedures: A comprehensive systematic review and meta-analysis
Authors' conclusion
S-ESP shows potential analgesic benefits, although the evidence is limited by high heterogeneity and low certainty
Study context
- Population
- Adults and children undergoing surgery (pelvic, perineal and lumbosacral and various procedures)14 RCTs (15 reports)
- Participants
- 1,041 adults
- Comparison
- S-ESP block vs control or alternative analgesic techniques
- Outcome
- Rescue analgesic requirement and time to first rescue analgesia
Methodological detailsrandom effects models, RoB 2, GRADE
- Random effects models
- RoB 2
- GRADE
Pooled result
As reported in the abstract
S-ESP vs ControlsRelative risk (95% CI)P value
Rescue analgesic requirement; I2 = 94.08%
0.59(0.38–0.89)
P = 0.01- Time to first rescue analgesia; I2 = 99.29%
- MD +5.33 h (95% CI 2.02–8.65); P < 0.001
Further pooled results
Adults vs children (subgroup)
- Benefits consistent in adults and children, stronger in adults for rescue analgesia requirement
Postoperative pain and quality of recovery
- Generally improved
Safety
Adverse events
- Rare and mild
Original publication
Efficacy and safety of sacral erector spinae plane (S-ESP) block in adult and pediatric patients during surgical procedures: A comprehensive systematic review and meta-analysis. J Clin Anesth. Published 11 March 2026. doi:10.
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