Paravertebral block is not superior to the interpectoral and pectoserratus plane block for patients undergoing breast surgery: An updated meta-analysis of randomised controlled trials with meta-regression and trial sequential analysis
Authors' conclusion
PVB and IP+PS blocks offer comparable analgesic efficacy and opioid-sparing effects after breast surgery, with no meaningful differences in 24-h MME consumption, pain scores, or PONV incidence.
Study context
- Population
- Patients undergoing breast surgery
- Participants
- 924 patients · 18 randomised controlled trials (RCTs)
- Comparison
- IP+PS block vs paravertebral block (PVB)
- Outcome
- Postoperative opioid consumption (MME)
- Follow-up
- 24 h
Methodological detailsmeta-regression, trial sequential analysis
- Meta-regression
- Trial sequential analysis
Pooled result
As reported in the abstract
MME consumption at 24 h
No significant difference in morphine milligram equivalent (MME) consumption at 24 h between the two techniques
MD −1.94 (−4.27 to 0.38, P = 0.101) (95% CI, P)
Further pooled results
| Outcome | MD (95% CI) | P value | |
|---|---|---|---|
| MME at 24 h, patients without axillary involvement (subgroup)Below the threshold of clinical significance | −2.42 (−3.56 to −1.29) | P < 0.001 | |
| −4−202Difference (linear scale) |
Pain scores and rescue analgesic requirements
- Comparable between PVB and IP+PS
Safety
Postoperative nausea and vomiting (PONV) incidence
- Comparable between PVB and IP+PS
Original publication
Paravertebral block is not superior to the interpectoral and pectoserratus plane block for patients undergoing breast surgery: An updated meta-analysis of randomised controlled trials with meta-regression and trial sequential analysis. Eur J Anaesthesiol. Published 12 February 2025. doi:10.
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