Erector Spinae Block in Bariatric Surgery: a Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Giovanna Macanhã Scremin, Pedro Bicudo Bregion, Victor Kenzo Ivano et al.
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In 30 seconds
This systematic review and meta-analysis assessed erector spinae plane block (ESPB) for postoperative analgesia in bariatric surgery. It included 9 randomized controlled trials with 553 patients. Compared with control, ESPB was associated with lower total opioid consumption (MD -9.53, 95% CI -15.10 to -3.96, p = 0.0008) and lower pain scores, including NRS scores (MD -1.15, 95% CI -1.76 to -0.55, p = 0.0002). The review also reported less postoperative nausea and vomiting, but no significant difference in respiratory complications.
Key findings
- ESPB was associated with reduced total opioid consumption (MD -9.53, 95% CI -15.10 to -3.96, p = 0.0008).
- NRS pain scores were lower with ESPB (MD -1.15, 95% CI -1.76 to -0.55, p = 0.0002).
- Postoperative nausea and vomiting incidence was significantly reduced, with consistent results across studies (I² = 0%).
- Respiratory complication incidence did not differ significantly between groups.
Why it matters
Postoperative pain and opioid exposure are important considerations after bariatric surgery. This synthesis of randomized trials suggests ESPB may improve pain control while reducing opioid use and postoperative nausea and vomiting. The findings can inform evaluation of regional analgesia as part of multimodal pain management, while the reported heterogeneity in some outcomes warrants caution in interpreting the size and consistency of benefit.
What to keep in mind
The review reports heterogeneity across studies for pain outcomes, including substantial heterogeneity for VAS scores during the first 12 h after surgery.