Hung Kuo-Chuan, Liu Wei-Cheng, Hsu Chih-Wei, Wu Jheng-Yan, Liao Shu-Wei, Chen I-Wen
Department of Anesthesiology, Chi Mei Medical Center, Tainan City, Taiwan.
School of Medicine, College of Medicine, National Sun Yat-Sen University, Kaohsiung City, Taiwan.
Obes Surg. 2025 Mar;35(3):1135-1145. doi: 10.1007/s11695-025-07724-9. Epub 2025 Jan 31.
This meta-analysis evaluated the analgesic efficacy of erector spinae plane block (ESPB) in metabolic surgery through analysis of ten randomized controlled trials (786 patients). ESPB demonstrated superior pain control compared to placebo from 2-12 h postoperatively, with peak effect at 6 h and sustained movement-related pain reduction through 24 h. ESPB showed comparable analgesic efficacy to other nerve blocks within 24 h postoperatively. The technique significantly reduced intraoperative and postoperative opioid consumption, extended time to first analgesic requirement, and decreased rescue analgesia needs. Additionally, ESPB recipients experienced reduced postoperative nausea and vomiting and shorter hospital stays. These findings support ESPB as an effective component of multimodal analgesia protocols for metabolic surgery, though standardization of techniques and long-term outcome studies are needed.
这项荟萃分析通过对10项随机对照试验（786例患者）进行分析，评估了竖脊肌平面阻滞（ESPB）在代谢手术中的镇痛效果。与安慰剂相比，ESPB在术后2至12小时显示出更好的疼痛控制，在6小时时达到峰值效应，并在24小时内持续减轻与活动相关的疼痛。ESPB在术后24小时内显示出与其他神经阻滞相当的镇痛效果。该技术显著减少了术中和术后阿片类药物的消耗量，延长了首次需要镇痛的时间，并减少了急救镇痛的需求。此外，接受ESPB的患者术后恶心和呕吐减少，住院时间缩短。这些发现支持ESPB作为代谢手术多模式镇痛方案的有效组成部分，不过仍需要技术标准化和长期结局研究。
