Effectiveness of erector spinae plane block in reducing opioid consumption after colorectal surgery: A comprehensive meta-analysis

Am J Surg. 2024 Jun:232:31-44. doi: 10.1016/j.amjsurg.2024.01.032. Epub 2024 Feb 2.

Abstract

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, I2 ​= ​87 ​%], intraoperative opioid consumption [MD ​= ​-35.51 ​mg; 95 ​% CI (-62.63 to -8.40); p ​= ​0.010, I2 ​= ​87 ​%], pain scores [MD ​= ​-0.94; 95 ​% CI (-1.27 to -0.60); p ​< ​0.000001, I2 ​= ​86 ​%], with a significantly shorter duration of hospital stay [MD ​= ​-1.25 days; 95 ​% CI (-2.02 to -0.48); p ​= ​0.002, I2 ​= ​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.

Keywords: Analgesia; Colorectal surgery; Erector spinae plane block; Opioid; Postoperative pain.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Review

MeSH terms

  • Analgesics, Opioid* / administration & dosage
  • Analgesics, Opioid* / therapeutic use
  • Humans
  • Nerve Block* / methods
  • Pain Management / methods
  • Pain, Postoperative* / prevention & control
  • Paraspinal Muscles* / innervation
  • Rectum / innervation
  • Rectum / surgery

Substances

  • Analgesics, Opioid