PDF(Pubmed)
Abstract：
BACKGROUND: Data on the effectiveness of erector spinae plane block (ESPB) for patients undergoing liver surgeries is limited and inconclusive. We hereby aimed to systematically review if ESPB can provide adequate analgesia after liver surgery.
METHODS: PubMed, CENTRAL, Scopus, Embase, and gray literature were examined up to 25th April 2023 for randomized controlled trials (RCTs) comparing ESPB with control or spinal analgesia.
RESULTS: Nine RCTs were included of which three compared ESPB with spinal analgesia. 24-hour opioid consumption did not differ significantly between ESPB vs. control (MD: -35.25 95% CI: -77.01, 6.52 I2 = 99%) or ESPB vs. spinal analgesia (MD: 2.32 95% CI: -6.12, 10.77 I2 = 91%). Comparing pain scores between ESPB and control, a small but significant effect favoring ESPB was noted at 12 h and 48 h, but not at 6-8 h and 24 h. Pain scores did not differ between ESPB and spinal analgesia. The risk of postoperative nausea and vomiting was also not significantly different between ESPB vs. control or spinal analgesia. GRADE assessment shows moderate certainty of evidence.
CONCLUSIONS: ESPB may not provide any significant postoperative analgesia in liver surgery patients. There was a tendency of reduced opioid consumption with ESPB. Limited data also showed that ESPB and spinal analgesia had no difference in pain scores and 24-hour analgesic consumption.
METHODS: PubMed, CENTRAL, Scopus, Embase, and gray literature were examined up to 25th April 2023 for randomized controlled trials (RCTs) comparing ESPB with control or spinal analgesia.
RESULTS: Nine RCTs were included of which three compared ESPB with spinal analgesia. 24-hour opioid consumption did not differ significantly between ESPB vs. control (MD: -35.25 95% CI: -77.01, 6.52 I2 = 99%) or ESPB vs. spinal analgesia (MD: 2.32 95% CI: -6.12, 10.77 I2 = 91%). Comparing pain scores between ESPB and control, a small but significant effect favoring ESPB was noted at 12 h and 48 h, but not at 6-8 h and 24 h. Pain scores did not differ between ESPB and spinal analgesia. The risk of postoperative nausea and vomiting was also not significantly different between ESPB vs. control or spinal analgesia. GRADE assessment shows moderate certainty of evidence.
CONCLUSIONS: ESPB may not provide any significant postoperative analgesia in liver surgery patients. There was a tendency of reduced opioid consumption with ESPB. Limited data also showed that ESPB and spinal analgesia had no difference in pain scores and 24-hour analgesic consumption.
摘要：
背景：关于竖脊肌平面阻滞（ESPB）对接受肝脏手术的患者的有效性的数据有限且尚无定论。我们在此旨在系统地审查ESPB是否可以在肝脏手术后提供足够的镇痛。
方法：PubMed，中部,Scopus,Embase,截至2023年4月25日,研究了有关比较ESPB与对照或脊髓镇痛的随机对照试验(RCT)的灰色文献.
结果：纳入了9个RCT，其中3个比较了ESPB与脊髓镇痛。ESPB与ESPB之间的24小时阿片类药物消耗没有显着差异。对照（MD：-35.2595％CI：-77.01，6.52I2=99％）或ESPB与脊髓镇痛(MD:2.3295%CI:-6.12,10.77I2=91%)。比较ESPB和对照组的疼痛评分，在12小时和48小时注意到有利于ESPB的小但显著的效果，但不是在6-8小时和24小时。ESPB和脊髓镇痛之间的疼痛评分没有差异。术后恶心和呕吐的风险在ESPB与控制或脊髓镇痛。等级评估显示证据的确定性适中。
结论：ESPB可能无法在肝脏手术患者中提供任何显著的术后镇痛效果。ESPB有减少阿片类药物消耗的趋势。有限的数据还显示，ESPB和脊髓镇痛在疼痛评分和24小时镇痛剂消耗方面没有差异。
方法：PubMed，中部,Scopus,Embase,截至2023年4月25日,研究了有关比较ESPB与对照或脊髓镇痛的随机对照试验(RCT)的灰色文献.
结果：纳入了9个RCT，其中3个比较了ESPB与脊髓镇痛。ESPB与ESPB之间的24小时阿片类药物消耗没有显着差异。对照（MD：-35.2595％CI：-77.01，6.52I2=99％）或ESPB与脊髓镇痛(MD:2.3295%CI:-6.12,10.77I2=91%)。比较ESPB和对照组的疼痛评分，在12小时和48小时注意到有利于ESPB的小但显著的效果，但不是在6-8小时和24小时。ESPB和脊髓镇痛之间的疼痛评分没有差异。术后恶心和呕吐的风险在ESPB与控制或脊髓镇痛。等级评估显示证据的确定性适中。
结论：ESPB可能无法在肝脏手术患者中提供任何显著的术后镇痛效果。ESPB有减少阿片类药物消耗的趋势。有限的数据还显示，ESPB和脊髓镇痛在疼痛评分和24小时镇痛剂消耗方面没有差异。
