Erector spinae plane block for postoperative analgesia in vertebral surgery: An updated meta-analysis of randomized controlled trials with trial sequential analysis and meta-regression
Pooled resultResult — go to the resultMD −8.89 mg MME 95% CI −11.44 to −6.33Authors' conclusion
There is low-certainty evidence supporting a modest reduction in 24-h opioid consumption and early postoperative pain with ESP block in patients undergoing vertebral surgery. In contrast, high-certainty evidence supports a significant reduction in the incidence of PONV.
Study context
- Population
- Adults undergoing vertebral surgery
- Participants
- 4,167 adults · 60 RCTs
- Comparison
- Erector spinae plane (ESP) block vs control
- ESP blockn = 2,081
- Controln = 2,086reference
- Outcome
- Postoperative opioid consumption (MME)
- Follow-up
- 24 h
Methodological detailstrial sequential analysis, meta-regression, random-effects models, prespecified subgroup analyses, sensitivity analysis
- Trial sequential analysis
- Meta-regression
- Random-effects models
- Prespecified subgroup analyses
- Sensitivity analysis
Pooled result
As reported in the abstract
MD
−8.89 mg MME
95% CI −11.44 to −6.33
P < 0.001
ESP block vs Control
MD −8.89 mg MME (95% CI −11.44 to −6.33); P < 0.001
Further pooled results
| Outcome | OR |
|---|---|
| PONVI2 = 0% · most consistent effect · high certainty | 0.40 |
Early postoperative pain scores and rescue analgesic use
- Favored the ESP block
- Low certainty for pain, moderate for rescue analgesia
Original publication
Erector spinae plane block for postoperative analgesia in vertebral surgery: An updated meta-analysis of randomized controlled trials with trial sequential analysis and meta-regression. J Clin Anesth. Published 19 March 2026. doi:10.
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