Analgesic efficacy of erector spinae plane block in lumbar spine surgery: A systematic review and meta-analysis

Erector spinae plane block (ESPB) has gained popularity for perioperative analgesia in various surgeries. However, its efficacy in lumbar surgery remains unclear. This review aimed to determine whether ESPB could improve analgesic efficacy in lumbar spine surgery. A meta-analysis of randomized contr...

Celý popis

Uložené v:
Podrobná bibliografia
Vydané v:Journal of clinical anesthesia Ročník 78; s. 110647
Hlavní autori: Oh, Seok Kyeong, Lim, Byung Gun, Won, Young Ju, Lee, Dong Kyu, Kim, Seong Shin
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: United States Elsevier Inc 01.06.2022
Elsevier Limited
Predmet:
Analgesics
Analgesics, Opioid
Anesthesia
Back surgery
Bias
Erector spinae plane block
Humans
Length of stay
Lumbar vertebrae
Meta-analysis
Narcotics
Nerve block
Nerve Block - methods
Neurosurgical procedures
Opioid analgesics
Pain
Pain Medicine
Pain, Postoperative - etiology
Pain, Postoperative - prevention & control
Paraspinal Muscles
Patient satisfaction
Postoperative Nausea and Vomiting - epidemiology
Postoperative Nausea and Vomiting - etiology
Postoperative Nausea and Vomiting - prevention & control
Systematic review
Thoracic surgery
Ultrasonic imaging
Vertebrae
Erector spinae plane block
Nerve block
Lumbar vertebrae
Neurosurgical procedures
Opioid analgesics
ISSN:0952-8180, 1873-4529, 1873-4529
On-line prístup:Získať plný text
Tagy: Pridať tag
Žiadne tagy, Buďte prvý, kto otaguje tento záznam!
Popis
Shrnutí:Erector spinae plane block (ESPB) has gained popularity for perioperative analgesia in various surgeries. However, its efficacy in lumbar surgery remains unclear. This review aimed to determine whether ESPB could improve analgesic efficacy in lumbar spine surgery. A meta-analysis of randomized controlled trials. Perioperative setting. Patients undergoing lumbar spine surgery under general anesthesia. We searched the databases including PubMed, Cochrane Library, EMBASE, Web of Science etc. for published eligible controlled trials comparing ESPB with control (no block/sham block) in lumbar spine surgery. The primary outcome was opioid consumption in the first 24 h after surgery. Twelve studies comprising 665 participants were included. Compared to the control, ESPB reduced the opioid (morphine milligram equivalents) consumption significantly 24 h after surgery [mean difference (MD) = −14.55; 95% confidence interval (CI), −21.03 to −8.07; P < 0.0001] and lowered the pain scores at various time points (at rest or during movement) for 48 h after surgery. ESPB increased the patient satisfaction score (0−10) (MD = 2.38; 95% CI, 2.10 to 2.66; P < 0.0001), decreased the postoperative nausea and vomiting [risk ratio (RR) = 0.36; 95% CI, 0.20 to 0.67; P = 0.001], and minimized the length of hospital stay (MD = −1.24 days; 95% CI, −2.31 to −0.18; P = 0.02). Furthermore, subgroup analysis revealed additional reduction in opioid consumption by the block approach at the vertebral level of incision/operation than that at the fixed thoracic/lumbar level. However, considerable heterogeneity and low-grade quality of evidence were observed. ESPB provided effective postoperative analgesia resulting in better patient satisfaction and recovery with decreased postoperative nausea and vomiting in patients undergoing lumbar surgery compared to the control. However, the low-grade quality of evidence compromised the findings, therefore further high-quality of evidence is required. PROSPERO registration number: CRD42021233362. •Evidence for ESPB use in lumbar spine surgery is insufficient.•We performed evidence synthesis of 12 RCTs on ESPB vs. control for lumbar surgery.•ESPB improved analgesic efficacy by reducing opioid consumption 24 h after surgery.•ESPB increased patient satisfaction and decreased postoperative nausea and vomiting.•ESPB at the incision/operation level reduced opioid use more than at the fixed level.
Bibliografia:ObjectType-Article-2
SourceType-Scholarly Journals-1
content type line 14
ObjectType-Feature-3
ObjectType-Evidence Based Healthcare-1
ObjectType-Article-1
ObjectType-Feature-2
ObjectType-Review-3
content type line 23
ObjectType-Undefined-4
ISSN:0952-8180
1873-4529
1873-4529
DOI:10.1016/j.jclinane.2022.110647