Erector spinae plane block versus transversus abdominis plane block for analgesia after cesarean section: a systematic review and meta-analysis
Background: Peripheral abdominal nerve blocks are key components of multimodal analgesia, enhancing recovery after cesarean sections. This systematic review and meta-analysis aimed to assess analgesic efficacy of Erector Spinae Plane Block (ESPB) versus Transversus Abdominis Plane Block (TAPB) under...
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Elsevier
2025-07-01
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| Series: | Brazilian Journal of Anesthesiology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001425000223 |
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| author | Mariana AbdElSayed Mansour Saeed Baradwan Ahmed Abdelaziz Shama Mohamed Ali Mahmoud Ayman Salah Abouelnour Ayman Mohamed AbdelWahed Mohamed Ahmed Fathi Hassan Elkhouly Abdelkarem Hussiny Ismail Elsayed Zaky Ftouh Rashed Ahmed Mohamed Abdelhakim Mrooj Mabruk Almutairi Mohamed A. Lotfy Ahmed Goda Ahmed |
| author_facet | Mariana AbdElSayed Mansour Saeed Baradwan Ahmed Abdelaziz Shama Mohamed Ali Mahmoud Ayman Salah Abouelnour Ayman Mohamed AbdelWahed Mohamed Ahmed Fathi Hassan Elkhouly Abdelkarem Hussiny Ismail Elsayed Zaky Ftouh Rashed Ahmed Mohamed Abdelhakim Mrooj Mabruk Almutairi Mohamed A. Lotfy Ahmed Goda Ahmed |
| author_sort | Mariana AbdElSayed Mansour |
| collection | DOAJ |
| description | Background: Peripheral abdominal nerve blocks are key components of multimodal analgesia, enhancing recovery after cesarean sections. This systematic review and meta-analysis aimed to assess analgesic efficacy of Erector Spinae Plane Block (ESPB) versus Transversus Abdominis Plane Block (TAPB) under ultrasound guidance following Cesarean Section (CS) under spinal anesthesia. Methods: A comprehensive search was conducted across PubMed, Scopus, Cochrane Library, and ISI Web of Science to identify relevant trials. The inclusion criteria followed the PICOS framework: Population (women undergoing elective cesarean delivery), Intervention (ESPB), Comparator (TAPB), Outcomes (postoperative pain, opioid consumption, analgesic duration, and satisfaction), and Study Design (randomized controlled trials). Results: Seven RCTs (380-patients) met the inclusion criteria. The ESPB group had significantly lower postoperative pain scores at rest and during movement, reduced 24-hour opioid consumption (MD = -2.62 MME; 95% CI -4.11 to -1.13; p = 0.006), and longer analgesic duration (SMD = 1.77; 95% CI 1.11 to 2.44; p < 0.001) than the TAPB group. Patient satisfaction was also significantly higher in the ESPB group (OR = 4.75; 95% CI 2.26 to 9.99; p < 0.001). While most outcomes demonstrated low heterogeneity, significant variability was observed in analgesic duration (I2 = 83%), requiring cautious interpretation. Conclusions: The ESP block offers superior pain relief, reduces opioid use, and enhances satisfaction compared to the TAP block in cesarean sections. These findings suggest that the implementation of the ESP block in postoperative analgesia protocols could significantly improve patient outcomes, potentially leading to enhanced recovery and reduced reliance on opioids. |
| format | Article |
| id | doaj-art-b500e252f59a4b01a09ac3c3a3a25752 |
| institution | Kabale University |
| issn | 0104-0014 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj-art-b500e252f59a4b01a09ac3c3a3a257522025-08-20T03:32:58ZengElsevierBrazilian Journal of Anesthesiology0104-00142025-07-0175484460610.1016/j.bjane.2025.844606Erector spinae plane block versus transversus abdominis plane block for analgesia after cesarean section: a systematic review and meta-analysisMariana AbdElSayed Mansour0Saeed Baradwan1Ahmed Abdelaziz Shama2Mohamed Ali Mahmoud3Ayman Salah Abouelnour4Ayman Mohamed AbdelWahed Mohamed5Ahmed Fathi Hassan Elkhouly6Abdelkarem Hussiny Ismail Elsayed7Zaky Ftouh Rashed8Ahmed Mohamed Abdelhakim9Mrooj Mabruk Almutairi10Mohamed A. Lotfy11Ahmed Goda Ahmed12Beni-Suef University, Faculty of Medicine, Department of Anesthesiology, Surgical Intensive Care and Pain Management, Beni-Suef, EgyptKing Faisal Specialist Hospital and Research Center, Department of Obstetrics and Gynecology, Jeddah, Saudi ArabiaTanta University, Faculty of Medicine, Department of Anesthesiology, Surgical Intensive Care and Pain Management, Tanta, EgyptAl-Azhar University, Faculty of Medicine, Department of Anesthesiology, Surgical Intensive Care and Pain Management, Assiut, EgyptAl-Azhar University, Faculty of Medicine, Department of Anesthesiology, Surgical Intensive Care and Pain Management, Cairo, EgyptAl-Azhar University, International Islamic Center for Population Studies and Research, Department of Anesthesiology, Surgical Intensive Care and Pain Management, Cairo, EgyptAl-Azhar University, Faculty of Medicine, Department of Anesthesiology, Surgical Intensive Care and Pain Management, Cairo, EgyptAl-Azhar University, Faculty of Medicine, Department of Anesthesiology, Surgical Intensive Care and Pain Management, Cairo, EgyptAl Maarefa University, College of Applied Sciences, Department of Anesthesia, Riyadh, Saudi ArabiaCairo University, Faculty of Medicine, Kasralainy, Cairo, Egypt; Corresponding author.King Abdulaziz University, Faculty of Medicine, Jeddah, Saudi ArabiaTanta University, Faculty of Medicine, Department of Anesthesiology, Surgical Intensive Care and Pain Management, Tanta, EgyptBeni-Suef University, Faculty of Medicine, Department of Anesthesiology, Surgical Intensive Care and Pain Management, Beni-Suef, EgyptBackground: Peripheral abdominal nerve blocks are key components of multimodal analgesia, enhancing recovery after cesarean sections. This systematic review and meta-analysis aimed to assess analgesic efficacy of Erector Spinae Plane Block (ESPB) versus Transversus Abdominis Plane Block (TAPB) under ultrasound guidance following Cesarean Section (CS) under spinal anesthesia. Methods: A comprehensive search was conducted across PubMed, Scopus, Cochrane Library, and ISI Web of Science to identify relevant trials. The inclusion criteria followed the PICOS framework: Population (women undergoing elective cesarean delivery), Intervention (ESPB), Comparator (TAPB), Outcomes (postoperative pain, opioid consumption, analgesic duration, and satisfaction), and Study Design (randomized controlled trials). Results: Seven RCTs (380-patients) met the inclusion criteria. The ESPB group had significantly lower postoperative pain scores at rest and during movement, reduced 24-hour opioid consumption (MD = -2.62 MME; 95% CI -4.11 to -1.13; p = 0.006), and longer analgesic duration (SMD = 1.77; 95% CI 1.11 to 2.44; p < 0.001) than the TAPB group. Patient satisfaction was also significantly higher in the ESPB group (OR = 4.75; 95% CI 2.26 to 9.99; p < 0.001). While most outcomes demonstrated low heterogeneity, significant variability was observed in analgesic duration (I2 = 83%), requiring cautious interpretation. Conclusions: The ESP block offers superior pain relief, reduces opioid use, and enhances satisfaction compared to the TAP block in cesarean sections. These findings suggest that the implementation of the ESP block in postoperative analgesia protocols could significantly improve patient outcomes, potentially leading to enhanced recovery and reduced reliance on opioids.http://www.sciencedirect.com/science/article/pii/S0104001425000223AnesthesiaCesarean sectionMeta-analysisObstetricsSystematic review |
| spellingShingle | Mariana AbdElSayed Mansour Saeed Baradwan Ahmed Abdelaziz Shama Mohamed Ali Mahmoud Ayman Salah Abouelnour Ayman Mohamed AbdelWahed Mohamed Ahmed Fathi Hassan Elkhouly Abdelkarem Hussiny Ismail Elsayed Zaky Ftouh Rashed Ahmed Mohamed Abdelhakim Mrooj Mabruk Almutairi Mohamed A. Lotfy Ahmed Goda Ahmed Erector spinae plane block versus transversus abdominis plane block for analgesia after cesarean section: a systematic review and meta-analysis Brazilian Journal of Anesthesiology Anesthesia Cesarean section Meta-analysis Obstetrics Systematic review |
| title | Erector spinae plane block versus transversus abdominis plane block for analgesia after cesarean section: a systematic review and meta-analysis |
| title_full | Erector spinae plane block versus transversus abdominis plane block for analgesia after cesarean section: a systematic review and meta-analysis |
| title_fullStr | Erector spinae plane block versus transversus abdominis plane block for analgesia after cesarean section: a systematic review and meta-analysis |
| title_full_unstemmed | Erector spinae plane block versus transversus abdominis plane block for analgesia after cesarean section: a systematic review and meta-analysis |
| title_short | Erector spinae plane block versus transversus abdominis plane block for analgesia after cesarean section: a systematic review and meta-analysis |
| title_sort | erector spinae plane block versus transversus abdominis plane block for analgesia after cesarean section a systematic review and meta analysis |
| topic | Anesthesia Cesarean section Meta-analysis Obstetrics Systematic review |
| url | http://www.sciencedirect.com/science/article/pii/S0104001425000223 |
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