Table 2.
Reported Studies of ESP Block
| Type of study | Intervention | N | Groups | NRS | Opioid consumption | Conclusion | |
|---|---|---|---|---|---|---|---|
| Tulgar et al. [104] | RCT | Laparoscopic Cholecystectomy | 30 | ESPB vs. control | 0–3 h: 1.00 ± 1.13 vs. 2.88 ± 1.79 (P < 0.01) | Fentanyl use: 6.66 ± 11.44 μg vs. 32.33 ± 22.69 μg (P < 0.001) | Bilateral ultrasound guided ESPB leads to effective analgesia and a decrease in opioid requirement in first 12 h |
| Gürkan et al. [105] | RCT | Breast surgery | 50 | ESPB vs. control | No statistically significant difference | Morphine at 24 h: 5.76 ± 3.80 mg vs. 16.60 ± 6.92 mg (P < 0.001) | ESPB exhibits a significant analgesic effect in patients undergoing breast cancer surgery. |
| Oksuz et al. [106] | RCT | Breast surgery | 43 | ESPB vs. Tumescent anesthesia | 0–24 h, all NRS of the ESPB group were significantly lower (P < 0.001) | Tramadol: 122.00 ± 56.74 mg vs. 196.00 ± 67.30 mg (P < 0.05) | Bilateral ESPB in breast reduction surgery was more effective than tumescent anesthesia concerning opioid consumption and pain scores. |
| Altiparmak et al. [107] | RCT | Breast surgery | 38 | ESPB vs. PECS | 1–24 h, all NRS of the PECS group were significantly lower (P < 0.05) | Tramadol: 196.00 ± 27.03 mg vs. 132.78 ± 22.44 mg (P = 0.001) | Modified PECS block reduced postoperative tramadol consumption and pain scores more effectively than ESPB after radical mastectomy. |
| Nagaraja et al. [108] | RCT | Cardiac surgery | 50 | ESPB vs. TEA | 0–12 h comparable NRS in both groups. 24–48 h NRS of the ESPB group were significantly lower (P < 0.05) | ESPB is a promising alternative to TEA in optimal perioperative pain management in cardiac surgery. | |
| Krishna et al. [109] | RCT | Cardiac surgery | 106 | ESPB vs. control | 0–24 h, all NRS of the ESPB group were significantly lower (P < 0.001) | Fentanyl use: 82.92 ± 4.29 μg vs. 214.25 ± 5.09 μg (P < 0.001) | ESPB provided significantly better pain relief for longer duration as compared to intravenous paracetamol and tramadol. |
| Macaire et al. [110] | CBAS | Cardiac surgery | 67 | ESPB vs. control | 2 h after chest tube removal 1 [0–2] vs. 2 [1.5–2.5], and 1 month after surgery 0.5 [0–3] vs. 2 [1–4] (P < 0.05) | Morphine in the first 48 h | ESPB is associated with a significant decrease in intraoperative and postoperative opioid consumption, optimized rapid patient mobilization, and chest tube removal after open cardiac surgery. |
| 0 [0–0] mg vs. 40 [25–45] mg (P < 0.001) | |||||||
| Tulgar et al. [111] | POS | Thoracotomy | 12 | Single level vs. Bilevel | First 12 h 2.66 [0–6] vs. 1.05 [1–3] | Tramadol (mg/day) 146.6 [100–270] vs. 60 [30–140] | Bi-level ESPB may possibly have an improved effect for postoperative analgesia when compared to conventional single level ESPB |
| Ueshima et al. [112] | ROS | Lumbar spine surgery | 41 | ESPB vs. control | 0–24 h, all NRS of the ESPB group were significantly lower (P < 0.05) | Fentanyl use: 40 [40–60] μg vs. 100 [80–100] μg (P < 0.05) | ESPB provides effective postoperative analgesic effect for 24 hours in patients undergoing lumbar spinal surgery. |
NRS: numbering rating scale, RCT: randomized controlled trial, CBAS: controlled before-and-after study, POS: prospective observational study, ROS: retrospective observational study, ESPB: erector spinae plane block, PECS: pectoral nerve block, TEA: thoracic epidural analgesia.