The erector spinae plane (ESP) block is a newly defined regional anesthesia technique first described in 2016. The aim of this meta-analysis is to assess the efficacy of ESP block in improving analgesia following lumbar surgery. PubMed, EMBASE, Cochrane Library, and Web of Science were searched for randomized controlled trials (RCTs) that compared the analgesic efficacy of the ESP block with non-block care for lumbar surgery from inception 3 August 2021. The primary outcomes were postoperative opioid consumption and pain scores during the first 24 h. Postoperative pain was measured as pain at rest and on movement at postoperative 0, 4, 8, 12, and 24 h expressed on a visual analog scale (VAS), where 0 = no pain and 10 = the most severe pain. 11 studies involving 775 patients were included in our analysis. The use of ESP block significantly decreased 24-h opioid consumption (WMD, -8.70; 95% CI, -10.48 to -6.93; I2 = 97.5%; P < 0.001) compared with the non-block. Moreover, ESP block reduced pain scores at postoperative time-points up to 24 h. ESP block also prolonged the time to first analgesic request (WMD = 6.93; 95% CI: 3.44 to 10.43, I2 = 99.8%; P < 0.001). There was less PONV with ESP block versus non-block group (RR, 0.354; 95% CI, 0.23 to 0.56; I2 = 25.2%; P < 0.001), but no difference in pruritus. ESP block provides less opioid consumption and PONV, lower pain scores, and longer time to first analgesic request in patients undergoing lumbar surgery compared to general anesthesia alone.

中文翻译：

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竖脊肌平面阻滞对腰椎手术术后镇痛的疗效：系统评价和荟萃分析

竖脊肌平面 (ESP) 阻滞是一种新定义的区域麻醉技术，于 2016 年首次描述。该荟萃分析的目的是评估 ESP 阻滞在改善腰椎手术后镇痛方面的疗效。在 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 中搜索了随机对照试验 (RCT)，这些试验从 2021 年 8 月 3 日开始比较了 ESP 阻滞与非阻滞护理对腰椎手术的镇痛效果。主要结果是术后阿片类药物的消耗量和最初 24 小时内的疼痛评分。术后疼痛测量为术后 0、4、8、12 和 24 小时的休息和运动疼痛，以视觉模拟量表 (VAS) 表示，其中 0 = 无疼痛，10 = 最严重的疼痛。涉及 775 名患者的 11 项研究被纳入我们的分析。与非阻断相比，ESP 阻滞的使用显着降低了 24 小时阿片类药物的消耗量（WMD，-8.70；95% CI，-10.48 至 -6.93；I2 = 97.5%；P < 0.001）。此外，ESP 阻滞可降低术后时间点长达 24 小时的疼痛评分。ESP 阻滞还延长了首次镇痛请求的时间（WMD = 6.93；95% CI：3.44 至 10.43，I2 = 99.8%；P < 0.001）。与非阻滞组相比，ESP 阻滞组的 PONV 较少（RR，0.354；95% CI，0.23 至 0.56；I2 = 25.2%；P < 0.001），但瘙痒无差异。与单纯全身麻醉相比，ESP 阻滞可减少接受腰椎手术的患者的阿片类药物消耗量和 PONV、较低的疼痛评分以及更长的首次镇痛请求时间。ESP 阻滞在术后时间点减少了长达 24 小时的疼痛评分。ESP 阻滞还延长了首次镇痛请求的时间（WMD = 6.93；95% CI：3.44 至 10.43，I2 = 99.8%；P < 0.001）。与非阻滞组相比，ESP 阻滞组的 PONV 较少（RR，0.354；95% CI，0.23 至 0.56；I2 = 25.2%；P < 0.001），但瘙痒无差异。与单纯全身麻醉相比，ESP 阻滞可减少接受腰椎手术的患者的阿片类药物消耗量和 PONV、较低的疼痛评分以及更长的首次镇痛请求时间。ESP 阻滞在术后时间点减少了长达 24 小时的疼痛评分。ESP 阻滞还延长了首次镇痛请求的时间（WMD = 6.93；95% CI：3.44 至 10.43，I2 = 99.8%；P < 0.001）。与非阻滞组相比，ESP 阻滞组的 PONV 较少（RR，0.354；95% CI，0.23 至 0.56；I2 = 25.2%；P < 0.001），但瘙痒无差异。与单纯全身麻醉相比，ESP 阻滞可减少接受腰椎手术的患者的阿片类药物消耗量和 PONV、较低的疼痛评分以及更长的首次镇痛请求时间。