Table 1.

Characteristics of included studies.

References	Year	Country	Surgery	Group (n)	Block level	Local anesthetics	Block timing	Opioid data	Nonopioid multimodal analgesia protocol	Pain score data form (early, middle, late period) (h)
Milligan et al.21	1993	Ireland	Elective lumbar discectomy	Control (30) WI (30)	10 ml into the wound, 5 ml laterally into the erector spini muscle, 5 ml subcutaneously along both margins of the wound	20 ml of 0.5% bupivacaine	Before wound closure	Morphine	NA	Table (1,8,24)
Mack et al.22	2001	USA	Single level, unilateral microscopic lumbar discectomy	Control (10) WI (10)	Into the wound	15 ml of 0.25% bupivacaine	Before wound closure	Morphine	NA	NA
Mirzai et al.23	2002	Turkey	Lumbar disc surgery for single-level unilateral herniated nucleus pulposus	Control (22) WI (22)	Paravertebral muscles and subcutaneous tissue	20 ml of 0.25% bupivacaine	During wound closure	Meperidine, NA for 24 h data	NA	Plot (1,12,NA)
Yörükoğlu et al.24	2005	Turkey	Elective surgery for lumbar disc disease within 3 hours	Control (20) WI (20)	Paraspinal muscle and skin	30 ml of 0.25% bupivacaine	Before wound closure	Meperidine	Naproxen sodium tablets (75 mg) as required	Plot (0.5,12,24)
Ersayli et al.25	2006	Turkey	Scheduled first unilateral lumbar discectomy	Control (15) WI (15)	Musculus multifidi near the operated level	30 ml of 0.25% bupivacaine	Before wound closure	Morphine	NA	Table (1,8,24)
Esmail et al.26	2008	Iran	Surgery for one level lumbar intervertebral disc herniation	Control (83) WI (83)	Subcutaneous tissue	20 ml of 2% lidocaine with 1/500 000 epinephrine	Before incision	Morphine (intramuscular)	NA	Table (6,12,24)
Gurbet et al.27	2008	Turkey	Surgery for unilateral lumbar disc herniation	Control (19) WI (19)	Musculus multifidi near the operated level	30 ml of 0.25% levobupivacaine	Before wound closure	Morphine	Diclofenac (75 mg) as rescue analgesic	NA
Ozyilmaz et al.28	2012	Turkey	Elective single space lumbar discectomy	Control (20) WI (20)	Over the incision line on the paravertebral muscles and cutaneous and subcutaneous tissue	20 ml of 0.75% levobupivacaine	Before wound closure	Pethidine	Diclofenac (75 mg) as rescue analgesic	Plot (1,12,24)
Mohta et al.33	2019	India	Tubercular spine surgery	Control (16) WI (16)	Wound	0.375% ropivacaine 3 mg/kg with adrenaline 5 μg/ml and dexmedetomidine 1 μg/kg in a total volume of 0.8 ml/kg	Before wound closure	Morphine	Diclofenac (1 mg/kg) or tramadol (1 mg/kg) at the time of wound closure	Plot (0.5,8,24)
Kraiwattanapong et al.39	2020	Thailand	One or two levels of lumbar spinous process splitting laminectomy due to degenerative lumbar spinal stenosis	Control (26) WI (23)	Wound (30 ml) and 20 ml for paraspinal muscle bilaterally	Total volume 50 ml of levobupivacaine 100 mg, morphine 5 mg, ketorolac tromethamine 30 mg, epinephrine 0.25 mg and normal saline	Unknown	Morphine	Pregabalin (75 mg) at bedtime postoperatively	Plot (0,12,24)
Ahiskalioglu et al.29	2018	Turkey	Scheduled for 2 or 3 level posterior lumbar instrumentation surgery	Control (20) TLIP (20)	L3, modified plane	20 ml of 0.25% bupivacaine	Unknown	Fentanyl	Non specified supplementary analgesia	Plot (1,12,24)
Ammar et al.30	2018	Egypt	Single or multiple level lumbar discectomy	Control (35) TLIP (35)	L3, original plane	20 ml of 0.25% bupivacaine, 20 ml of 1% lidocaine	After induction	Morphine	Intravenous paracetamol (1 g) every 6 h	Plot (2,12,24)
Chen et al.31	2019	China	Lumbosacral spine fusion surgery	Control (30) TLIP (30)	L3, original plane	30 ml of 0.375% ropivacaine	After induction	Sufentanil	Intravenous flurbiprofen (50 mg) at end of surgery	Plot (1,12,24)
Ozmen et al.34	2019	Turkey	Elective single-level herniated lumbar disc surgery	Control (40) TLIP (40)	L3, modified plane	40 ml of 0.25% bupivacaine	Before induction	Fentanyl	Dexketoprofen (50 mg) at near end of surgery and postoperative 12 h	Plot (1,12,24)
Eltaher et al.42	2021	Egypt	Elective spine surgery (discectomy, laminectomy, and spinal fixation)	Control (30) TLIP (30)	L3, original plane	40 ml of 0.25% bupivacaine	Unknown	Morphine	Intravenous paracetamol (1 g) every 8 h	Table (2,12,24)
El Ghamry et al.32	2019	Egypt	Elective posterior lumbar interbody fusion due to double level lumbar spondylolisthesis (L3–L5)	Control (30) ESPB (30)	L3	40 ml of 0.25% bupivacaine	Before induction	Morphine	Intravenous paracetamol (1 g) every 6 h, Ketorolac loading (30 mg) and every 8 h (15 mg)	Plot (2,12,24)
Yayik et al.35	2019	Turkey	One or two-level open lumbar decompression surgery	Control (30) ESPB (30)	L3	40 ml of 0.25% bupivacaine	Before induction	Tramadol	Ibuprofen (400 mg) every 12 h	Table (2,12,24)
Eskin et al.38	2020	Turkey	Elective lumbar decompression surgery for one or two vertebral levels	Control (40) ESPB (40)	The vertebra in the middle of the incision line	40 ml of 0.25% bupivacaine	After surgery	Tramadol	Intravenous paracetamol 10 mg/kg, tenoxicam 10 mg After induction, Intravenous paracetamol (1 g) every 8 h, Dexketoprofen (50 mg) every 24 h	Table (2,12,24)
Singh et al.40	2020	India	Elective lumbar spine surgery (prolapsed lumbar intervertebral disk, lumbar stenosis, or laminectomy)	Control (20) ESPB (20)	T10	40 ml of 0.5% bupivacaine	Before induction	Morphine	Intravenous diclofenac (1.5 mg/kg) every 8 h	Table (0,12,24)
Zhang et al.41	2020	China	Open posterior lumbar decompression surgery (prolapsed lumbar intervertebral disk, lumbar stenosis)	Control (30) ESPB (30)	T12	50 ml of 0.3% ropivacaine	Before induction	Morphine	NA	Table (NA, NA,24)
Finnerty et al.43	2021	Ireland	Open thoracolumbar vertebral decompression for degenerative stenosis or trauma at two or more levels, with or without fusion	Control (30) ESPB (30)	Mid-point of the planned incision	40 ml of 0.25% levobupivacaine	After induction	Oxycodone	Intravenous paracetamol (1 g) and dexketoprofen (50 mg) after induction, Intravenous paracetamol (1 g) every 6 h, Oral ibuprofen (400 mg) every 8 h	Plot (0,12,24)
Goel et al.44	2021	India	Elective single-level transforaminal lumbar interbody fusion surgery	Control (50) ESPB (51)	Surgical level	40 ml of 0.25% bupivacaine	After induction	Fentanyl	Intravenous paracetamol (1 g) and ketorolac (30 mg) after induction, Intravenous paracetamol (1 g) every 6 h, ketorolac (30 mg) every 8 h, and pregabalin (75 mg) once a day	Table (2,12,24)
Jin et al.45	2021	China	Elective two-level or three-level lumbar laminoplasty for lumbar spinal stenosis	Control(32) ESPB(30)	Vertebral levels of the surgery	40 ml of 0.375% ropivacaine	After induction	Oral morphine milligram equivalent	Intravenous parecoxib (40 mg and intramuscular pethidine (50 mg) as rescue analgesic	Plot (1,12,24)
Wahdan et al.46	2021	Egypt	Lumbar spine procedures on any two levels between L1 and L5 (discectomy, laminectomy, and fixation)	Control (70) ESPB (70)	Operating level	40 ml of 0.25% levobupivacaine	After induction	Morphine	Intravenous ketorolac (30 mg) every 8 h	Plot (0,12,24)
Yeşiltaş et al.48	2021	Turkey	Posterior spinal instrumentation and fusion for spondylolisthesis	Control (28) ESPB (28)	Freehand ESPB technique directly by the surgical team under vision	20 ml (1:1) mixture solution of 0.25% bupivacaine and 1.0% lidocaine 0.25% bupivacaine and 1.0% lidocaine	End of surgery	Morphine	Paracetamol every 8 h	Table (1,12,24)
Yörükoğlu et al.49	2021	Turkey	Elective single-level lumbar microdiscectomy	Control (26) ESPB (28)	Surgical level	40 ml of 0.25% bupivacaine	Before surgery	Morphine	Tramadol (100 mg) and paracetamol (1 g) at end of surgery, Intravenous tenoxicam (20 mg) as recue analgesic	Table (1,12,24)
Yu et al.50	2021	China	Posterior internal fixation for single-level lumbar fracture	Control (40) ESPB (40)	Fractured lumbar vertebra	60 ml of 0.25% bupivacaine	After induction	Sufentanil	Flurbiprofen included in patient controlled analgesia	Table (6,12,24)
Zhang et al.51	2021	China	Lumbar spine surgery	Control (29) ESPB (30)	T10	50 ml of 0.3% ropivacaine	Before induction	Morphine	Flurbiprofen (50 mg), dezocine (0.1–0.2 mg/kg) and dexmedetomidine (0.3 μg/kg)	Table (NA, NA,24)
Zhang et al.52	2021	China	Primary open posterior lumbar spinal fusion surgery	Control (30) ESPB (30)	L3	40 ml of 0.4% ropivacaine	Before surgery	Sufentanil	Flurbiprofen (1.5 mg/kg) loading at end of surgery and continuous infusion (6 mg/h)	Plot (4,12,24)
Zhu et al.53	2021	China	Posterior lumbar fusion surgery	Control (20) ESPB (20)	L2	40 ml of 0.375% ropivacaine	Before surgery	Oxycodone	Flurbiprofen (50 mg) before the end of surgery	Table (0.5,12,24)
Asar et al.54	2022	Turkey	Elective spinal surgery with instrumentation involving single or multilevels in the lumbar or thoracic regions	Control (35) ESPB (35)	T10	Total 40 ml volume consisting of 20 ml of 0.5% bupivacaine, 10 ml of 2% lidocaine, and 10 ml of 0.9% NaCl	End of surgery	Total morphine equivalent dose	Intravenous paracetamol (1 g) and tramadol (1 mg/kg) before the end of surgery	Plot (1,12,24)
Ekinci et al.37	2020	Turkey	Single-level lumbar disc surgery	WI (30) TLIP (30)	Surgery site (WI) L3 (TLIP), modified plane	20 ml of 0.5% bupivacaine (WI) 40 ml of 0.25% bupivacaine (TLIP)	After induction	Fentanyl	Intravenous paracetamol (1 g) every 8 h	Table (2,8,24)
Ciftci et al.36	2020	Turkey	Single-level lumbar discectomy and hemilaminectomy surgery	Control (30) TLIP (30) ESPB (30)	L3, modified plane	40 ml of 0.25% bupivacaine	After induction	Fentanyl	Intravenous paracetamol (1 g) every 6 h	Table (2,8,24)
Wang et al.47	2021	China	Lumbar spine fusion surgery	Control (100) TLIP (102) ESPB (102)	L3 (TLIP), original plane T12 (ESPB)	30 ml of 0.375% ropivacaine	After induction	Sufentanil, NA for 24 h data	Flurbiprofen included in patient controlled analgesia	Plot (1,12,24)

ESPB, erector spinae plane block; NA, not applicable; TLIP, thoracolumbar interfascial plane; WI, wound infiltration.