Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Department of Medicine, Karachi Medical and Dental College, Karachi, Pakistan.
Am J Surg. 2024 Jun;232:31-44. doi: 10.1016/j.amjsurg.2024.01.032. Epub 2024 Feb 2.
Despite the life-saving nature of colorectal surgeries, patients often experience intra and post-operative problems, especially pain and discomfort. This meta-analysis aimed to evaluate the effectiveness of erector spinae plane block (ESP block) in postoperative pain management for patients undergoing colorectal surgeries. A comprehensive systematic literature search was conducted in PubMed and Cochrane Library databases from inception until December 2023. Eight studies were deemed appropriate for inclusion. The pooled analysis demonstrated a significant decrease with the ESP block compared to the control group in postoperative opioid consumption [MD = -15.96 mg; 95 % CI (-28.74 to -3.18); p = 0.014, I = 87 %], intraoperative opioid consumption [MD = -35.51 mg; 95 % CI (-62.63 to -8.40); p = 0.010, I = 87 %], pain scores [MD = -0.94; 95 % CI (-1.27 to -0.60); p < 0.000001, I = 86 %], with a significantly shorter duration of hospital stay [MD = -1.25 days; 95 % CI (-2.02 to -0.48); p = 0.002, I = 23 %]. This meta-analysis support the use of erector spinae plane block (ESP) for postoperative pain management in colorectal surgeries. ESP shows significant reductions in opioid consumption, pain scores and hospital stay.
尽管结直肠手术具有救生性质，但患者经常会经历围手术期问题，尤其是疼痛和不适。本荟萃分析旨在评估竖脊肌平面阻滞（ESP 阻滞）在结直肠手术后患者的术后疼痛管理中的有效性。在 PubMed 和 Cochrane Library 数据库中进行了全面的系统文献检索，检索时间从创建到 2023 年 12 月。有 8 项研究被认为适合纳入。汇总分析表明，与对照组相比，ESP 阻滞组术后阿片类药物消耗[MD=-15.96mg；95%CI（-28.74 至-3.18）；p=0.014，I=87%]、术中阿片类药物消耗[MD=-35.51mg；95%CI（-62.63 至-8.40）；p=0.010，I=87%]、疼痛评分[MD=-0.94；95%CI（-1.27 至-0.60）；p<0.000001，I=86%]均显著降低，住院时间[MD=-1.25 天；95%CI（-2.02 至-0.48）；p=0.002，I=23%]显著缩短。这项荟萃分析支持在结直肠手术中使用竖脊肌平面阻滞（ESP）进行术后疼痛管理。ESP 可显著减少阿片类药物消耗、疼痛评分和住院时间。
