Efficacy of erector spinae plane block for analgesia in breast surgery: a systematic review and meta‐analysis

Summary The erector spinae plane block is a new regional anaesthesia technique that provides truncal anaesthesia for breast surgery. This systematic review and meta‐analysis was undertaken to determine if the erector spinae plane block is effective at reducing pain scores and opioid consumption afte...

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Bibliographic Details
Published in:Anaesthesia 2021-03, Vol.76 (3), p.404-413
Main Authors: Leong, R. W., Tan, E. S. J., Wong, S. N., Tan, K. H., Liu, C. W.
Format: Article
Language:English
Subjects:
acute pain
Adult
Analgesia - methods
Breast - surgery
erector spinae plane block
Female
Humans
Nerve Block - methods
Pain, Postoperative - prevention & control
Paraspinal Muscles - drug effects
paravertebral block
pectoralis nerve block
post‐surgical pain
regional anaesthesia
Treatment Outcome
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Summary:Summary The erector spinae plane block is a new regional anaesthesia technique that provides truncal anaesthesia for breast surgery. This systematic review and meta‐analysis was undertaken to determine if the erector spinae plane block is effective at reducing pain scores and opioid consumption after breast surgery. This study also evaluated the outcomes of erector spinae plane blocks compared with other regional blocks. PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov were searched. We included randomised controlled trials reporting the use of the erector spinae plane block in adult breast surgery. Risk of bias was assessed with the revised Cochrane risk‐of‐bias tool. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework was used to assess trial quality. Thirteen randomised controlled trials (861 patients; 418 erector spinae plane block, 215 no blocks, 228 other blocks) were included. Erector spinae plane block reduced postoperative pain compared with no block: at 0‐2 hours (mean difference (95% CI) −1.63 (−2.97 to −0.29), 6 studies, 329 patients, high‐quality evidence, I2 = 98%, p = 0.02); at 6 hours (mean difference (95% CI) −0.90 (−1.49 to −0.30), 5 studies, 250 patients, high‐quality evidence, I2 = 91%, p = 0.003); at 12 hours (mean difference (95% CI) −0.46 (−0.67 to −0.25), 5 studies, 250 patients, high‐quality evidence, I2 = 58%, p 
ISSN:0003-2409
1365-2044
DOI:10.1111/anae.15164