The Analgesic Efficacy of Erector Spinae Plane Block in Patients Undergoing Nephrectomy: A Systematic Review and...

The present investigation is the first systematic review and meta-analysis assessing analgesic efficacy of erector spinae plane blocks (ESPB) in patients undergoing nephrectomies. ESPBs have shown promise in various surgeries, but their efficacy in nephrectomy has not been comprehensively evaluated. This study compares patients that underwent nephrectomies with ESPBs and general anesthesia versus patients that had general anesthesia only. We performed a systematic search for studies from PubMed, Google Scholar, Embase, and Cochrane. Sources were considered for inclusion in the review if they were randomized controlled trials published from July 2014 to present in English. Data on postoperative opioid consumption, intraoperative opioid use, pain scores, and time to first analgesic request was extracted. The data was analyzed using EndNote, Rayyan, and RevMan software.

Our analysis included 7 studies with a total of 352 patients. ESPBs significantly reduced postoperative opioid consumption (mean difference = -11.28 mg IV (intravenous) morphine equivalents; 95% CI (confidence interval), -15.33 to -7.22; P < 0.00001) and intraoperative opioid use (mean difference = -0.08 mg IV fentanyl equivalents; 95% CI, -0.09 to -0.08; P < 0.00001). Also, the time to the first analgesic request was significantly longer in the ESPB group (mean difference = 52.86 min; 95% CI, 50.24 to 55.48; P < 0.00001). Pain scores were consistently lower in the ESPB group at various postoperative intervals. ESPBs effectively reduce both opioid consumption and pain scores in nephrectomy patients. This approach can minimize opioid-related side effects and improve recovery.