nach oben

European Spine Journal

Erschienen in:

13.05.2021 | Review Article

Erector spinae plane block for postoperative analgesia in spine surgery: a systematic review and meta-analysis

verfasst von: Jun Ma, Yaodan Bi, Yabing Zhang, Yingchao Zhu, Yujie Wu, Yu Ye, Jie Wang, Tianyao Zhang, Bin Liu

Erschienen in: European Spine Journal | Ausgabe 11/2021

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Although in recent years some randomized controlled trails (RCTs) have explored the analgesic effect of erector spinae plane block (ESPB) in spine surgery, their results are controversial. Our study aimed to examine the analgesic effect of preoperative ESPB in spine surgery by a meta-analysis of RCTs.

Methods

The articles of RCTs that compared preoperative ESPB with no block in terms of the analgesic effect in adult patients following spine surgery were eligible for inclusion. The primary outcome was the pain scores reported by Visual Analog Scale or Numerical Rating Scale of pain at different time intervals in 48 h after surgery. The secondary outcomes included postoperative opioid consumption, rescue analgesia requirement, opioid-related side effects and complications associated with ESPB.

Results

Twelve studies involving 828 patients were eligible for our study. Compared with no block, ESPB had a significant effect on reducing postoperative pain scores at rest and at movement at different time intervals except at movement at 48 h. ESPB significantly decreased opioid consumption in 24 h after surgery (SMD − 1.834; 95%CI − 2.752, − 0.915; p < 0.001; I² = 89.0%), and reduced the incidence of rescue analgesia (RR 0.333; 95%CI 0.261, 0.425; p < 0.001; I² = 0%) and postoperative nausea and vomiting (RR 0.380; 95%CI 0.272, 0.530; p < 0.001; I² = 9.0%). Complications associated with ESPB were not reported in the included studies.

Conclusion

Our meta-analysis demonstrates that ESPB is effective in decreasing postoperative pain intensity and postoperative opioid consumption in spine surgery. Therefore, for the management of postoperative pain following spine surgery, preoperative ESPB is a good choice.

Hughey AB, Lesniak MS, Ansari SA, Roth S (2010) What will anesthesiologists be anesthetizing? trends in neurosurgical procedure usage. Anesth Analg 110(6):1686–1697. https://doi.org/10.1213/ANE.0b013e3181cbd9ccCrossRefPubMed

Gerbershagen HJ, Aduckathil S, van Wijck AJ, Peelen LM, Kalkman CJ, Meissner W (2013) Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology 118(4):934–944. https://doi.org/10.1097/ALN.0b013e31828866b3CrossRefPubMed

Bajwa SJ, Haldar R (2015) Pain management following spinal surgeries: an appraisal of the available options. Journal of craniovertebral junction & spine 6(3):105–110. https://doi.org/10.4103/0974-8237.161589CrossRef

Dunn LK, Durieux ME, Nemergut EC (2016) Non-opioid analgesics: novel approaches to perioperative analgesia for major spine surgery. Best Pract Res Clin Anaesthesiol 30(1):79–89. https://doi.org/10.1016/j.bpa.2015.11.002CrossRefPubMed

Perkins FM, Kehlet H (2000) Chronic pain as an outcome of surgery. A Review Predict Fact Anesthesiol 93(4):1123–1133. https://doi.org/10.1097/00000542-200010000-00038CrossRef

Gan TJ (2017) Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res 10:2287–2298. https://doi.org/10.2147/jpr.s144066CrossRefPubMedPubMedCentral

Kurd MF, Kreitz T, Schroeder G, Vaccaro AR (2017) The role of multimodal analgesia in spine surgery. J Am Acad Orthop Surg 25(4):260–268. https://doi.org/10.5435/jaaos-d-16-00049CrossRefPubMed

Mergeay M, Verster A, Van Aken D, Vercauteren M (2015) Regional versus general anesthesia for spine surgery. A comprehensive review Acta anaesthesiologica Belgica 66(1):1–9PubMed

Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ (2016) The erector spinae plane block: a novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med 41(5):621–627. https://doi.org/10.1097/aap.0000000000000451CrossRefPubMed

10.

Urits I, Charipova K, Gress K, Laughlin P, Orhurhu V, Kaye AD, Viswanath O (2019) Expanding role of the erector spinae plane block for postoperative and chronic pain management. Curr Pain Headache Rep 23(10):71. https://doi.org/10.1007/s11916-019-0812-yCrossRefPubMed

11.

Tulgar S, Aydin ME, Ahiskalioglu A, De Cassai A, Gurkan Y (2020) Anesthetic techniques: focus on lumbar erector spinae plane block. Local Reg Anesth 13:121–133. https://doi.org/10.2147/LRA.S233274CrossRefPubMedPubMedCentral

12.

Chin KJ, Malhas L, Perlas A (2017) The erector spinae plane block provides visceral abdominal analgesia in bariatric surgery: a report of 3 cases. Reg Anesth Pain Med 42(3):372–376. https://doi.org/10.1097/aap.0000000000000581CrossRefPubMed

13.

Gürkan Y, Aksu C, Kuş A, Yörükoğlu UH, Kılıç CT (2018) Ultrasound guided erector spinae plane block reduces postoperative opioid consumption following breast surgery: a randomized controlled study. J Clin Anesth 50:65–68. https://doi.org/10.1016/j.jclinane.2018.06.033CrossRefPubMed

14.

Ciftci B, Ekinci M, Celik EC, Tukac IC, Bayrak Y, Atalay YO (2020) Efficacy of an ultrasound-guided erector spinae plane block for postoperative analgesia management after video-assisted thoracic surgery: a prospective randomized study. J Cardiothorac Vasc Anesth 34(2):444–449. https://doi.org/10.1053/j.jvca.2019.04.026CrossRefPubMed

15.

Qiu Y, Zhang TJ, Hua Z (2020) Erector spinae plane block for lumbar spinal surgery: a systematic review. J Pain Res 13:1611–1619. https://doi.org/10.2147/jpr.s256205CrossRefPubMedPubMedCentral

16.

Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6(7):e1000100. https://doi.org/10.1371/journal.pmed.1000100CrossRefPubMedPubMedCentral

17.

Higgins JP, Altman DG, Gøtzsche PC, Jüni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA (2011) The Cochrane collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clinical research ed) 343:d5928. https://doi.org/10.1136/bmj.d5928CrossRef

18.

Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ (Clinical research ed) 315(7109):629–634. https://doi.org/10.1136/bmj.315.7109.629CrossRef

19.

Hozo SP, Djulbegovic B, Hozo I (2005) Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol 5:13. https://doi.org/10.1186/1471-2288-5-13CrossRefPubMedPubMedCentral

20.

DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188. https://doi.org/10.1016/0197-2456(86)90046-2CrossRefPubMed

21.

Wang W, Liu YL, Zhang YY (2018) Ultrasound-guided erector spine block as an adjuvant to general anesthesia and postoperative analgesia in patients undergoing lumbar spine surgery. J Clin Anesthesiol 34(12):1172–1175. https://doi.org/10.12089/jca.2018.12.007 (in Chinese)CrossRef

22.

Zhang XX (2018) Application of the Ultrasound-guided Erector Spinae Plane Block in Lumbar Spinal Surgery. Dissertation, North China University of Science and Technology. (in Chinese)

23.

Yayik AM, Cesur S, Ozturk F, Ahiskalioglu A, Ay AN, Celik EC, Karaavci NC (2019) Postoperative analgesic efficacy of the ultrasound-guided erector spinae plane block in patients undergoing lumbar spinal decompression surgery: a randomized controlled study. World Neurosurg 126:e779–e785. https://doi.org/10.1016/j.wneu.2019.02.149CrossRefPubMed

24.

Liu CF (2019) Effect of ultrasound-guided single erector spinae block for postoperative pain in lumbar spine surgery. Dissertation, Nanchang University (in Chinese)

25.

Liu TZ, Hua L, Wan L (2019) Comparison of ultrasound-guided erector spinae plane block and retrolaminal block combined with general anesthesia for patients undergoing vertebral surgery. J Clin Anesthesiol 35(3):289–293. https://doi.org/10.12089/jca.2019.03.018 (in Chinese)CrossRef

26.

Wu X, Xue F, Wang J, Yang L, Chen XD, Yao SL (2019) Analgesic efficacy of ultrasound-guided bilateral erector spinae plane block in patients undergoing posterior lumbar interbody fusion. J Clin Anesthesiol 35(9):842–845. https://doi.org/10.12089/jca.2019.09.002 (in Chinese)CrossRef

27.

Ciftci B, Ekinci M, Celik EC, Yayik AM, Aydin ME, Ahiskalioglu A (2020) Ultrasound-guided erector spinae plane block versus modified-thoracolumbar interfascial plane block for lumbar discectomy surgery: a randomized. World Neurosurgery, Controlled Study. https://doi.org/10.1016/j.wneu.2020.09.077CrossRef

28.

Eskin MB, Ceylan A, Özhan MÖ, Atik B (2020) Ultrasound-guided erector spinae block versus mid-transverse process to pleura block for postoperative analgesia in lumbar spinal surgery. Anaesthesist 69(10):742–750. https://doi.org/10.1007/s00101-020-00848-wCrossRefPubMed

29.

Singh S, Choudhary NK, Lalin D, Verma VK (2020) Bilateral ultrasound-guided erector spinae plane block for postoperative analgesia in lumbar spine surgery: a randomized control trial. J Neurosurg Anesthesiol 32(4):330–334. https://doi.org/10.1097/ana.0000000000000603CrossRefPubMed

30.

Liu XM, Fu JN, Li J (2020) Postoperative analgesia effect of bilateral erector spinae plane block combined with intravenous analgesia in patients undergoing spinal surgery. People’s Military Surg 63(09):889–892 (in Chinese)

31.

Peng C (2020) Effects of ultrasound-guided erector spinae plane block on analgesia and immune function in posterior lumbar surgery in elderly patients. Dissertation, Nanchang university. (in Chinese)

32.

Zhang XQ (2020) Analgesic effect of erector spinae muscle block after posterior lumbar spine surgery. Dissertation, Xinjiang medical university. (in Chinese)

33.

Yang HM, Choi YJ, Kwon HJ, O J, Cho TH, Kim SH (2018) Comparison of injectate spread and nerve involvement between retrolaminar and erector spinae plane blocks in the thoracic region: a cadaveric study. Anaesthesia 73(10):1244–1250. https://doi.org/10.1111/anae.14408CrossRefPubMed

34.

Celik M, Tulgar S, Ahiskalioglu A, Alper F (2019) Is high volume lumbar erector spinae plane block an alternative to transforaminal epidural injection? evaluation with MRI. Reg Anesth Pain Med. https://doi.org/10.1136/rapm-2019-100514CrossRefPubMed

35.

Greenhalgh K, Womack J, Marcangelo S (2019) Injectate spread in erector spinae plane block. Anaesthesia 74(1):126–127. https://doi.org/10.1111/anae.14523CrossRefPubMed

36.

Vidal E, Giménez H, Forero M, Fajardo M (2018) Erector spinae plane block: a cadaver study to determine its mechanism of action. Rev Esp Anestesiol Reanim 65(9):514–519. https://doi.org/10.1016/j.redar.2018.07.004CrossRef

37.

Yamak Altinpulluk E, García Simón D, Fajardo-Pérez M (2018) Erector spinae plane block for analgesia after lower segment caesarean section: case report. Rev Esp Anestesiol Reanim 65(5):284–286. https://doi.org/10.1016/j.redar.2017.11.006CrossRef

38.

Chin KJ, Adhikary S, Sarwani N, Forero M (2017) The analgesic efficacy of pre-operative bilateral erector spinae plane (ESP) blocks in patients having ventral hernia repair. Anaesthesia 72(4):452–460. https://doi.org/10.1111/anae.13814CrossRefPubMed

39.

Hacibeyoglu G, Topal A, Arican S, Kilicaslan A, Tekin A, Uzun ST (2018) USG guided bilateral erector spinae plane block is an effective and safe postoperative analgesia method for living donor liver transplantation. J Clin Anesth 49:36–37. https://doi.org/10.1016/j.jclinane.2018.06.003CrossRefPubMed

40.

Tulgar S, Kapakli MS, Senturk O, Selvi O, Serifsoy TE, Ozer Z (2018) Evaluation of ultrasound-guided erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: a prospective, randomized, controlled clinical trial. J Clin Anesth 49:101–106. https://doi.org/10.1016/j.jclinane.2018.06.019CrossRefPubMed

41.

Hand WR, Taylor JM, Harvey NR, Epperson TI, Gunselman RJ, Bolin ED, Whiteley J (2015) Thoracolumbar interfascial plane (TLIP) block: a pilot study in volunteers. Can J Anaesth 62(11):1196–1200. https://doi.org/10.1007/s12630-015-0431-yCrossRefPubMed

42.

Ahiskalioglu A, Alici HA, Selvitopi K, Yayik AM (2017) Ultrasonography-guided modified thoracolumbar interfascial plane block: a new approach. Can J Anaesth 64(7):775–776. https://doi.org/10.1007/s12630-017-0851-yCrossRefPubMed

43.

Ahiskalioglu A, Yayik AM, Alici HA (2017) Ultrasound-guided lateral thoracolumbar interfascial plane (TLIP) block: description of new modified technique. J Clin Anesth 40:62. https://doi.org/10.1016/j.jclinane.2017.04.015CrossRefPubMed

44.

Costache I, de Neumann L, Ramnanan CJ, Goodwin SL, Pawa A, Abdallah FW, McCartney CJL (2017) The mid-point transverse process to pleura (MTP) block: a new end-point for thoracic paravertebral block. Anaesthesia 72(10):1230–1236. https://doi.org/10.1111/anae.14004CrossRefPubMed

45.

Voscopoulos C, Palaniappan D, Zeballos J, Ko H, Janfaza D, Vlassakov K (2013) The ultrasound-guided retrolaminar block. Can J Anaesth 60(9):888–895. https://doi.org/10.1007/s12630-013-9983-xCrossRefPubMed

Titel: Erector spinae plane block for postoperative analgesia in spine surgery: a systematic review and meta-analysis
verfasst von: Jun Ma
Yaodan Bi
Yabing Zhang
Yingchao Zhu
Yujie Wu
Yu Ye
Jie Wang
Tianyao Zhang
Bin Liu
Publikationsdatum: 13.05.2021
Verlag: Springer Berlin Heidelberg
Erschienen in: European Spine Journal / Ausgabe 11/2021
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-021-06853-w

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen.
» Jetzt entdecken

Neu im Fachgebiet Orthopädie und Unfallchirurgie

Tennisarm: „Ein bisschen Physio würde ich mich schon trauen“

06.06.2024 Schmerzsyndrome Nachrichten

Eine Therapie mit nachgewiesenem Nutzen gibt es bei Epicondylitis lateralis derzeit nicht. Das heißt jedoch nicht, dass man die Betroffenen mit ihren Beschwerden allein lassen sollte, so der Rat eines Experten. Gute Erfahrungen habe er zum Beispiel mit der Stoßwellentherapie gemacht.

Knie-TEP: Kein Vorteil durch antibiotikahaltigen Knochenzement

29.05.2024 Periprothetische Infektionen Nachrichten

Zur Zementierung einer Knie-TEP wird in Deutschland zu über 98% Knochenzement verwendet, der mit einem Antibiotikum beladen ist. Ob er wirklich besser ist als Zement ohne Antibiotikum, kann laut Registerdaten bezweifelt werden.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 11/2021

How helpful is the halo-gravity traction in severe spinal deformity patients?: A systematic review and meta-analysis

16th German Spine Congress Annual Meeting of the German Spine Society 9th to 11th December 2021 Muenster, Germany

Matching correction of main and compensatory curves is critical for immediate postoperative coronal balance in correction of severe adult idiopathic scoliosis

Adult spinal deformity surgery: posterior three-column osteotomies vs anterior lordotic cages with posterior fusion. Complications, clinical and radiological results. A systematic review of the literature

Predictive model of global tilt (GT) determined by individual thoracic kyphosis, lumbar lordosis and pelvic incidence in the human degenerative spine