Efficacy of erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized controlled trials
Introduction: Erector spinae plane block (ESPB) is a relatively newer approach to the paraspinal fascial plane block. The analgesic efficacy of this block is presently being established in percutaneous nephrolithotomy (PCNL). This meta-analysis was designed to assess the effectiveness of ESPB as a p...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Journal of Anaesthesiology Clinical Pharmacology |
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| Online Access: | https://journals.lww.com/10.4103/joacp.joacp_403_23 |
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| author | Ajay Singh Aditya Prakash Sharma Venkata Ganesh Rekha Gupta Gopal Sharma Naveen B. Naik Priyanka Sethi Narender Kaloria Prerna Varma |
| author_facet | Ajay Singh Aditya Prakash Sharma Venkata Ganesh Rekha Gupta Gopal Sharma Naveen B. Naik Priyanka Sethi Narender Kaloria Prerna Varma |
| author_sort | Ajay Singh |
| collection | DOAJ |
| description | Introduction:
Erector spinae plane block (ESPB) is a relatively newer approach to the paraspinal fascial plane block. The analgesic efficacy of this block is presently being established in percutaneous nephrolithotomy (PCNL). This meta-analysis was designed to assess the effectiveness of ESPB as a perioperative analgesic technique when compared with conventional analgesia (control) in PCNL.
Material and Methods:
We performed a systematic review and meta-analysis on the use of ESPB for perioperative analgesia in PCNL for renal stone disease. A systematic literature search was conducted in PubMed, Scopus, ProQuest, and EMBASE using the terms ((erector spinae plane block) AND ((Analgesia) OR (visual analogue scale) OR (VAS) OR (opioid*) OR (morphine) OR (tramadol))) AND ((percutaneous nephrolithotomy) OR (PCNL)) with an intention to include all the randomized studies comparing ESPB with the control group. The risk of bias was assessed using RoB2.
Results:
A total of 187 records were identified and after the exclusions, a total of 10 trials (560 patients, 503 for primary outcome) were included. Pain scores were significantly lower in the ESPB group as compared to the control group except at the 12th postoperative hour. There were significantly better pain scores at 24 h in the ESPB group as compared to the control group (Standardized mean difference (SMD) −0.46, 95% CI (−1.05, 0.13), moderate GRADE evidence). The total opioid consumption was significantly lower in the ESPB group (SMD −1.50, 95% CI (−1.7 to −1.29, moderate GRADE evidence).
Conclusions:
ESPB is more effective than conventional analgesia in terms of postoperative opioid consumption after PCNL. Future studies should incorporate better double-blinding techniques, transparent reporting of methods, and sham controls (such as additional dressing post general anesthesia) which were lacking in the current studies. |
| format | Article |
| id | doaj-art-fdcec911af8342148daa28e5d9bd9794 |
| institution | OA Journals |
| issn | 2231-2730 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Anaesthesiology Clinical Pharmacology |
| spelling | doaj-art-fdcec911af8342148daa28e5d9bd97942025-08-20T02:13:36ZengWolters Kluwer Medknow PublicationsJournal of Anaesthesiology Clinical Pharmacology2231-27302025-01-01411627210.4103/joacp.joacp_403_23Efficacy of erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized controlled trialsAjay SinghAditya Prakash SharmaVenkata GaneshRekha GuptaGopal SharmaNaveen B. NaikPriyanka SethiNarender KaloriaPrerna VarmaIntroduction: Erector spinae plane block (ESPB) is a relatively newer approach to the paraspinal fascial plane block. The analgesic efficacy of this block is presently being established in percutaneous nephrolithotomy (PCNL). This meta-analysis was designed to assess the effectiveness of ESPB as a perioperative analgesic technique when compared with conventional analgesia (control) in PCNL. Material and Methods: We performed a systematic review and meta-analysis on the use of ESPB for perioperative analgesia in PCNL for renal stone disease. A systematic literature search was conducted in PubMed, Scopus, ProQuest, and EMBASE using the terms ((erector spinae plane block) AND ((Analgesia) OR (visual analogue scale) OR (VAS) OR (opioid*) OR (morphine) OR (tramadol))) AND ((percutaneous nephrolithotomy) OR (PCNL)) with an intention to include all the randomized studies comparing ESPB with the control group. The risk of bias was assessed using RoB2. Results: A total of 187 records were identified and after the exclusions, a total of 10 trials (560 patients, 503 for primary outcome) were included. Pain scores were significantly lower in the ESPB group as compared to the control group except at the 12th postoperative hour. There were significantly better pain scores at 24 h in the ESPB group as compared to the control group (Standardized mean difference (SMD) −0.46, 95% CI (−1.05, 0.13), moderate GRADE evidence). The total opioid consumption was significantly lower in the ESPB group (SMD −1.50, 95% CI (−1.7 to −1.29, moderate GRADE evidence). Conclusions: ESPB is more effective than conventional analgesia in terms of postoperative opioid consumption after PCNL. Future studies should incorporate better double-blinding techniques, transparent reporting of methods, and sham controls (such as additional dressing post general anesthesia) which were lacking in the current studies.https://journals.lww.com/10.4103/joacp.joacp_403_23erector spinae plane blockmeta-analysispercutaneous nephrolithotomyregional anesthesia |
| spellingShingle | Ajay Singh Aditya Prakash Sharma Venkata Ganesh Rekha Gupta Gopal Sharma Naveen B. Naik Priyanka Sethi Narender Kaloria Prerna Varma Efficacy of erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized controlled trials Journal of Anaesthesiology Clinical Pharmacology erector spinae plane block meta-analysis percutaneous nephrolithotomy regional anesthesia |
| title | Efficacy of erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized controlled trials |
| title_full | Efficacy of erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized controlled trials |
| title_fullStr | Efficacy of erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized controlled trials |
| title_full_unstemmed | Efficacy of erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized controlled trials |
| title_short | Efficacy of erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy: A systematic review and meta-analysis of randomized controlled trials |
| title_sort | efficacy of erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy a systematic review and meta analysis of randomized controlled trials |
| topic | erector spinae plane block meta-analysis percutaneous nephrolithotomy regional anesthesia |
| url | https://journals.lww.com/10.4103/joacp.joacp_403_23 |
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