Efficacy of erector spinae plane block for postoperative pain management: A meta-analysis and trial sequential analysis of randomized controlled trials

Gonçalves, JPF; Duran, ML; Barreto, ESR; Antunes Júnior, CR; Albuquerque, LG; Lins-Kusterer, LEF; Azi, LMTA; Kraychete, DC

doi:10.1016/j.jclinane.2025.111831

Pain medicine

Efficacy of erector spinae plane block for postoperative pain management: A meta-analysis and trial sequential analysis of randomized controlled trials

J Clin AnesthPublished 7 Apr 2025Systematic review and meta-analysis of randomised controlled trials

Read the original article ↗PubMed

Cite

Authors' conclusion

ESPB is a safe and effective regional anesthesia technique that significantly reduces postoperative pain and opioid consumption across various surgical procedures.

Study context

Population: Surgical patients43 randomized controlled trials (RCTs)

Comparison: ESP block vs placebo or sham block
Erector Spinae Plane Block (ESPB)n = 1,361
Outcome: Postoperative pain; intraoperative and cumulative postoperative opioid consumption (24 h); PONV, pruritus and block-related adverse events
Follow-up: 2 h, 6 h, 24 h and 48 h (pain)

Methodological detailstrial sequential analysis, subgroup and sensitivity analyses, meta-regression

Trial sequential analysis
Subgroup and sensitivity analyses
Meta-regression

Pooled result

As reported in the abstract

Postoperative pain

ESPB vs Placebo or sham blockMD (95 % CI)P value

2 h; I2 = 91 %

−1.46(−1.98 to −0.94)

P < 0.001

6 h; I2 = 89 %

−1.23(−1.64 to −0.83)

P < 0.001

24 h; I2 = 78 %

−0.47(−0.67 to −0.28)

P < 0.001

48 h; I2 = 10 %

−0.24(−0.39 to −0.09)

P = 0.002

Further pooled results

Outcome	← Lower with ESPB ←→ Higher with ESPB →	MD (μg) (95 % CI)	P value
Intraoperative opioid consumption (primary outcome)I2 = 100 %	−300−200−1000100	−137.43 (−208.73 to −66.13)	P < 0.001
	−300−200−1000100Difference, μg (linear scale)

Outcome	← Lower with ESPB ←→ Higher with ESPB →	MD (mg) (95 % CI)	P value
Cumulative opioid consumption (primary outcome) · 24 hI2 = 99 %	−40−20020	−25.62 (−31.31 to −19.93)	P < 0.001
	−40−20020Difference, mg (linear scale)

Trial sequential analysis (TSA)

No further trials needed to assess ESPB efficacy in the analysed outcomes, except postoperative pruritus

Safety

Outcome	← Lower risk with ESPB ←→ Higher risk with ESPB →	RR (95% CI)	P value
PONV incidenceI2 = 16 %	0.512	0.56 (0.44–0.72)	P < 0.001
	0.512Relative risk (log scale)

Block-related adverse events

No block-related adverse events reported in any study

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Efficacy of erector spinae plane block for postoperative pain management: A meta-analysis and trial sequential analysis of randomized controlled trials. J Clin Anesth. Published 7 April 2025. doi:10.1016/j.jclinane.2025.111831

Read the original article ↗

Composed by AI from the published abstract and checked against it. How Briefs are made →