Analgesic effects of erector spinae plane block for patients after breast surgery: a systematic review and meta-analysis

OBJECTIVE: This meta-analysis investigated the analgesic effects of erector spinae plane block (ESPB) in patients undergoing breast surgery. METHODS: PubMed, Embase, Web of Science, and the Cochrane Library were searched from database establishment to January 31, 2020. Two reviewers independently extracted the data. The primary outcomes were pain scores and opioid consumption during the first 24 hours after surgery. The risk of bias of the included studies was assessed according to the Cochrane Handbook. RESULTS: Six randomized controlled trials of 415 patients were included. Compared with the control value, the pain score was significantly lower in the ESPB group at different time points postoperatively. Patients who underwent ESPB required lower opioid consumption (standardized mean difference = −2.02, 95% confidence interval [CI] = −2.85 to −1.20, I(2)= 91%. The rates of postoperative nausea (risk ratio [RR] = 0.79, 95% CI = 0.48–1.30, I(2) = 47%) and postoperative vomiting (RR = 0.76, 95% CI = 0.30–1.96, I(2) = 33%) did not differ between the groups. The quality of evidence was low or very low. CONCLUSIONS: ESPB significantly alleviated pain and reduced opioid consumption after breast surgery. Further research is needed to expand its clinical application. PROSPERO registration number CRD42020167900