The Efficacy of Erector Spinae Plane Block for Thoracoscopic Surgery: A Meta-Analysis of Randomized Controlled Trials.

ABSTRACT

BACKGROUND: The efficacy of erector spinae plane block for thoracoscopic surgery remains controversial. We conducted a systematic review and meta-analysis to explore the impact of erector spinae plane block on thoracoscopic surgery. METHODS: We searched the PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through February 2022 for randomized controlled trials (RCTs), assessing the effect of erector spinae plane block on thoracoscopic surgery. This meta-analysis was performed using the random-effect model. RESULTS: Seven RCTs, involving 439 patients, are included in the meta-analysis. Overall, compared with the control group for thoracoscopic surgery, erector spinae plane block (ESPB) results in significantly reduced pain scores at 1 h (standard mean difference (SMD) = -4.26; 95% confidence interval (CI) = -7.63 to -0.88; p = 0.01), 4 h (SMD = -4.08; 95% CI = -4.56 to -3.60; p < 0.00001), 8 h (SMD = -4.13; 95% CI = -4.62 to -3.65; p < 0.00001), and postoperative anesthesia consumption (SMD = -3.04; 95% CI = -4.58 to -1.50; p = 0.0001) and can decrease the incidence of nausea and vomiting (odd ratio (OR) = 0.18; 95% CI = 0.08 to 0.39; p < 0.001). CONCLUSIONS: ESPB can substantially enhance pain relief for thoracoscopic surgery.