Erector Spinae Plane Block Versus Transversus Abdominis Plane Block for Postoperative Analgesia in Bariatric Surgery:...

Managing postoperative pain in patients following bariatric surgery is challenging. Although transversus abdominis plane block (TAPB) and erector spinae plane block (ESPB) have proved effective for pain relief, the analgesic efficacy between them remains controversial. This network meta-analysis was conducted to compare the postoperative analgesic efficacy of ESPB and TAPB in bariatric surgery.

PubMed, Embase, Web of Science, and Cochrane Library databases were systematically searched to select randomised controlled trials (RCTs) examining the analgesic efficacy of ESPB or TAPB in bariatric surgery. The primary outcome was 24-hour postoperative opioid consumption. Secondary outcomes included postoperative pain scores at early, middle, and late period, and time to first rescue analgesia. Network meta-analysis (NMA) was conducted using a frequentist approach.

Fourteen RCTs involving 1,063 patients were eligible for this NMA. This NMA showed that ESPB ranked highest in reducing 24-hour postoperative opioid consumption (0.970), decreasing middle and late postoperative pain scores (0.936 and 0.897, respectively), and prolonging the time to first rescue analgesia (0.955). However, TAPB was the best choice for early-pain relief (0.847).

Both techniques can provide effective postoperative analgesia, while ESPB is more effective in reducing 24-hour postoperative opioid consumption, alleviating middle and late postoperative pain, and prolonging the time to first rescue analgesia. However, further studies are needed to determine the optimal postoperative analgesic regimen for bariatric surgery.