Department of Anesthesiology, The Second Hospital of Jilin University, Changchun, 130041, China.
Department of Ophthalmology, The Second Hospital of Jilin University, Changchun, 130041, China.
BMC Anesthesiol. 2023 Feb 16;23(1):54. doi: 10.1186/s12871-023-02013-3.
The erector spinae plane (ESP) block is a newly defined regional anesthesia technique first described in 2016. The aim of this meta-analysis is to assess the efficacy of ESP block in improving analgesia following lumbar surgery.
PubMed, EMBASE, Cochrane Library, and Web of Science were searched for randomized controlled trials (RCTs) that compared the analgesic efficacy of the ESP block with non-block care for lumbar surgery from inception 3 August 2021. The primary outcomes were postoperative opioid consumption and pain scores during the first 24 h. Postoperative pain was measured as pain at rest and on movement at postoperative 0, 4, 8, 12, and 24 h expressed on a visual analog scale (VAS), where 0 = no pain and 10 = the most severe pain.
11 studies involving 775 patients were included in our analysis. The use of ESP block significantly decreased 24-h opioid consumption (WMD, -8.70; 95% CI, -10.48 to -6.93; I = 97.5%; P < 0.001) compared with the non-block. Moreover, ESP block reduced pain scores at postoperative time-points up to 24 h. ESP block also prolonged the time to first analgesic request (WMD = 6.93; 95% CI: 3.44 to 10.43, I = 99.8%; P < 0.001). There was less PONV with ESP block versus non-block group (RR, 0.354; 95% CI, 0.23 to 0.56; I = 25.2%; P < 0.001), but no difference in pruritus.
ESP block provides less opioid consumption and PONV, lower pain scores, and longer time to first analgesic request in patients undergoing lumbar surgery compared to general anesthesia alone.
竖脊肌平面（ESP）阻滞是一种新定义的区域麻醉技术，于 2016 年首次描述。本荟萃分析的目的是评估 ESP 阻滞在改善腰椎手术后镇痛效果的作用。
从 2021 年 8 月 3 日起，我们在 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 中检索了比较 ESP 阻滞与腰椎手术后非阻滞护理镇痛效果的随机对照试验（RCT）。主要结局是术后 24 小时内阿片类药物的消耗量和疼痛评分。术后疼痛通过术后 0、4、8、12 和 24 小时的静息和运动时的疼痛评分来衡量，采用视觉模拟评分（VAS）表示，其中 0=无疼痛，10=最严重疼痛。
纳入的 11 项研究共 775 例患者。与非阻滞组相比，ESP 阻滞显著减少了 24 小时内阿片类药物的消耗（WMD，-8.70；95%CI，-10.48 至-6.93；I=97.5%；P<0.001）。此外，ESP 阻滞还降低了术后至 24 小时的疼痛评分。ESP 阻滞还延长了首次镇痛需求的时间（WMD=6.93；95%CI：3.44 至 10.43，I=99.8%；P<0.001）。与非阻滞组相比，ESP 阻滞组发生术后恶心呕吐（PONV）的情况更少（RR，0.354；95%CI，0.23 至 0.56；I=25.2%；P<0.001），但瘙痒发生率无差异。
与单纯全身麻醉相比，ESP 阻滞可减少腰椎手术患者的阿片类药物消耗和 PONV、降低疼痛评分、延长首次镇痛需求的时间。
