Review Article

Efficacy of Postoperative Analgesia by Erector Spinal Plane Block after Lumbar Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Table 1

The features of the included trials.

Author/yearParticipants ()AgeType of surgeryTechniquesESPB groupControl groupPostoperative analgesiaRescue analgesia

Ciftci et al. (2021) [6]6018–65 years1-level lumbar discectomy and hemilaminectomy surgeryUSG-guided ESPB40 mL of 0.25% bupivacaineNo blockPCIA fentanyl, 1 g paracetamol every 6 hoursMeperidine (0.5 mg/kg)
Eskin et al. (2020) [7]8018–80 years1- or 2-level lumbar decompression surgeryUSG-guided ESPB20 mL of 0.25% bupivacaineNo blockPCIA tramadolMeperidine (0.5 mg/kg)
Elgebaly et al. (2019) [8]6018–60 years2-level lumbar spondylolisthesis (L3-L5)USG-guided ESPB20 mL of 0.25% bupivacaineSham blocks (20 ml normal saline)Paracetamol 1 gm/6 hours and ketorolac 30 mg loading dose then 15 mg/8 hoursMorphine 0.1 mg/kg iv.
Goel et al. (2021) [12]10018–78 years1-level transforaminal lumbar interbody fusion surgeryUSG-guided ESPB20 mL of 0.25% bupivacaineNo block1 gm paracetamol iv. Sixth hourly, 30 mg iv. ketorolac eighth hourly, pregabalin capsule 75 mg once a dayFentanyl 1 mcg/kg iv.
Siam et al. (2020) [13]30>18 yearsLumbar spine surgeryUSG-guided ESPB20 mL of 0.25% bupivacaineKetorolac 0.75 mg/kg and paracetamol 10 mg/kg0.5 mg/kg peridine
Singh et al. (2019) [14]4018–65 yearsLumbar spine surgeryUSG-guided ESPB20 mL of 0.5% bupivacaineNo blockiv. diclofenac 1.5 mg/kg every 8 hoursiv. morphine 3 mg on demand or
Finnerty and Buggy (2021) [15]14018–65 years2-level lumbar spine surgeryUSG-guided ESPB20 mL of 0.25% levobupivacaine20 mL of normal saline 0.9%iv. ketorolac 30 mg every 8 hourly, PCIA morphineiv. Morphine
Yayik et al. (2019) [16]6018–65 years1- or 2-level open lumbar decompression surgeryUSG-guided ESPB20 mL of 0.025% bupivacaineNo block400 mg IV ibuprofen 12 hourly; PCIA tramadol25 mg pethidine
Yeşiltaş et al. (2021) [17]56>18 yearsOpen posterior instrumentation and fusionFree-hand ESPB20 mL (1 : 1) mixture solution of 0.25% bupivacaine and 1.0% lidocaineSham blocks (20 mL physiological saline)iv. 1 mg/kg tramadol, 1 g paracetamol25 mg pethidine
Yörükoğlu et al. (2021) [18]5418–65 years1-level lumbar microdiscectomyUSG-guided ESPB20 mL of 0.25% bupivacaineSham blocks (20 mL normal saline)Tramadol (100 mg) and paracetamol (1 g), PCIA morphineTenoxicam 20 mg IV (NRS was >3)
Yu et al. (2021) [19]8026-67 years1-level lumbar fractureUSG-guided ESPB30 mL of 0.25% bupivacaineSham blocks (normal saline)PCIA sufentanil and flurbiprofenim. pethidine (NRS was >4)
Zhang et al. (2021) [20]6018–75 yearsLumbar spine surgeryUSG-guided ESPB25 mL of 0.3% ropivacaineNo blockPCIA morphinePCIA bolus
Zhang et al. (2021) [21]6020–75 yearsOpen posterior lumbar spinal fusion surgeryUSG-guided ESPB20 mL 0.4% ropivacaineSham blocksiv. flurbiprofen 300 mg, PCIA sufentanilPCIA bolus
Zhang et al. (2020) [22]6018–80 yearsOpen posterior lumbar spinal fusion surgeryUSG-guided ESPB25 mL of 0.3% ropivacaineNo blockPCIA morphinePCIA bolus
Zhu et al. (2021) [23]4045–70 yearsLumbar fusionUSG-guided ESPB20 mL of 0.375% ropivacaineSham blocks (normal saline)iv. sufentanil 5 μg, flurbiprofen 50 mg, PCIA oxycodoneiv. sufentanil 5 μg