Paravertebral Block versus Erector Spinae Plane Block for Postoperative Analgesia and Recovery: A Systematic Review...

Area of Science:

• Anesthesiology
• Pain Management
• Surgical Recovery

Background:

• Postoperative pain management is crucial for patient recovery.
• Paravertebral block (PVB) and erector spinae plane block (ESPB) are regional anesthesia techniques used for analgesia.
• Comparative efficacy of PVB and ESPB requires systematic evaluation.

Purpose of the Study:

• To systematically review and meta-analyze randomized controlled trials (RCTs).
• To compare the relative efficacy of PVB and ESPB for postoperative analgesia and recovery.
• To assess outcomes including pain scores, quality of recovery, and adverse events.

Main Methods:

• Systematic review and meta-analysis of 33 RCTs involving 2256 patients.
• Searched major databases (PubMed, Embase, etc.) up to January 2025.
• Assessed certainty of evidence using risk of bias and GRADE frameworks.

Main Results:

• No significant difference between PVB and ESPB for resting Visual Analogue Scale (VAS) at 6 hours or quality of recovery (QoR) scores.
• ESPB showed lower VAS at 12 hours; PVB demonstrated lower morphine consumption.
• No significant differences in VAS at 24 hours, movement pain, rescue analgesia time, length of stay, or postoperative nausea and vomiting (PONV).

Conclusions:

• No significant clinical differences were found between PVB and ESPB regarding VAS, QoR, rescue analgesia, length of stay, and PONV.
• ESPB is recommended for thoracic, breast, kidney, and abdominal surgeries based on current evidence.
• Variability in protocols and lack of long-term data highlight areas for future research.