The Effect of Single-Shot Erector Spinae Plane Block (ESPB) on Opioid Consumption for Various Surgeries: A Meta-Analysis of Randomized Controlled Trials

Figures & data

Figure 1 Flow chart of search strategy to identify the eligible randomized controlled trials.

Table 1 Summary of Details About the Enrolled Trials

Study	Sample Size (n)	Type of Surgery	Intervention/ Control	Dose (Each Side)	Outcomes
Zhu, 2021^Citation10	40	Lumbar Fusion	ESPB vs Sham block	20 mL of 0.375% ropivacaine	①③④⑤
Zhang, 2020^Citation21	60	Lumbar Surgery	ESPB vs No block	25 mL of 0.3% ropivacaine	①②④⑤
Zhang, 2021^Citation22	60	Lumbar spinal fusion	ESPB vs Sham block	20 mL of 0.4% ropivacaine	①④⑤
Yeşiltaş, 2021^Citation11	56	Lumbar Spondylolisthesis	ESPB vs Sham block	20 mL (1:1) mixture solution of 0.25% bupivacaine and 1.0% lidocaine	①②③④⑤
Yayik, 2019^Citation23	60	Lumbar spinal decompression surgery	ESPB vs No block	20mL of 0.25% bupivacaine	①②③④⑤
Yao, 2020^Citation24	79	Modified radical mastectomy	ESPB vs Sham block	25 mL of 0.5% ropivacaine	①④⑤
Yao, 2020^Citation25	75	Video-assisted thoracic surgery	ESPB vs Sham block	25 mL of 0.5% ropivacaine	①④⑤
Wang, 2019^Citation26	100	Radical mastectomy	ESPB vs No block	20 mL of 0.375% ropivacaine	①④⑤
Wahdan, 2021^Citation27	140	Lumbar spine surgery	ESPB vs Sham block	20 mL of 0.25% levobupivacaine	①②④⑤
Tulgar, 2018^Citation28	40	Hip and proximal femur surgery	ESPB vs No block	20 mL of 0.5% bupivacaine, 10 mL of 2% lidocaine, 10 mL of normal saline	①③
Tulgar, 2018^Citation29	30	Laparoscopic cholecystectomy	ESPB vs No block	20 mL of 0.375% ropivacaine	①③
Tulgar, 2019^Citation30	40	Laparoscopic cholecystectomy	ESPB vs No block	20 mL of bupivacaine 0.5%, 10 mL of lidocaine 2% and 10 mL of normal saline	①③
Singh, 2019^Citation31	40	Modified radical mastectomy	ESPB vs No block	20 mL of 0.5% bupivacaine	①③④⑤
Singh, 2020^Citation32	40	Lumbar spine surgery	ESPB vs No block	20 mL of 0.5% bupivacaine	①②③④⑤
Siam, 2020^Citation33	40	Lumbar spine surgery	ESPB vs No block	20 mL of 0.25% bupivacaine	①②
Shim, 2020^Citation34	46	Video-assisted thoracoscopic surgery	ESPB vs Sham block	30 mL of 0.5% ropivacaine	①④⑤
Sharma, 2020^Citation35	60	Total mastectomy and axillary clearance	ESPB vs No block	0.4mL/kg of 0.5% ropivacaine	①④⑤
Seelam, 2020^Citation36	100	Mastectomy	ESPB vs No block	30 mL of 0.25% of bupivacaine	①③⑤
Prasad, 2020^Citation37	61	Percutaneous nephrolithotomy	ESPB vs No block	20 mL of 0.375% ropivacaine	①②③④⑤
Park, 2021^Citation38	58	Mastectomy and immediate breast reconstruction with a tissue expander	ESPB vs No block	30 mL of 0.375% ropivacaine	①③④⑤
Oksuz, 2019^Citation39	43	Reduction Mammoplasty	ESPB vs No block	20 mL of 0.5% bupivacaine	①③④⑤
Mostafa, 2021^Citation40	60	Laparoscopic bariatric surgery	ESPB vs Sham block	20 mL of 0.25% bupivacaine	①②④⑤
Liu, 2021^Citation12	80	Video-assisted thoracoscopic surgery	ESPB vs No block	25 mL of 0.4% ropivacaine	①②④⑤
Kwon, 2020^Citation41	53	Laparoscopic cholecystectomy	ESPB vs No block	20 mL of 0.20% ropivacaine	①④⑤
Krishna, 2018^Citation42	106	Cardiac surgery	ESPB vs No block	3 mg/kg of 0.375% ropivacaine	①④⑤
Kim, 2021^Citation43	70	Laparoscopic liver resection	ESPB vs No block	20 mL of 0.5% ropivacaine	①④⑤
Ibrahim, 2019^Citation44	50	Percutaneous nephrolithotomy	ESPB vs Sham block	30mL of 0.25% bupivacaine	①②④⑤
Ibrahim, 2020^Citation45	42	Laparoscopic cholecystectomy	ESPB vs Sham block	20 mL of 0.25% bupivacaine hydrochloride	①②④⑤
Hamed, 2019^Citation46	60	Total abdominal hysterectomy	ESPB vs Sham block	20 mL of 0.5% bupivacaine	①④⑤
Gürkan, 2018^Citation47	50	Breast surgery	ESPB vs No block	20 mL of 0.25% bupivacaine	①④⑤
Gürkan, 2020^Citation48	50	Breast surgery	ESPB vs No block	20 mL of 0.25% bupivacaine	①④
Gultekin, 2019^Citation49	50	Percutaneous nephrolithotomy	ESPB vs No block	20 mL of 0.5% bupivacaine	①②
Ghamry, 2019^Citation50	60	Lumbar interbody fusion	ESPB vs No block	20 mL of 0.25% bupivacaine	①②④⑤
Fu, 2020^Citation51	60	Hepatectomy	ESPB vs No block	20 mL of 0.5% ropivacaine	①④⑤
Finnerty, 2021^Citation52	60	Thoracolumbar decompressive spinal surgery	ESPB vs Sham block	20 mL of 0.25% levobupivacaine	①⑤
Eskin, 2020^Citation53	80	Lumbar spinal surgery	ESPB vs No block	20 mL of 0.25% bupivacaine	①②③④⑤
Elsabeeny, 2020^Citation54	50	Breast cancer surgery	ESPB vs No block	25 mL of 0.25% bupivacaine	①②③⑤
Dost, 2021^Citation55	50	Open radical prostatectomy	ESPB vs Sham block	10 mL of 1% lidocaine and 10 mL of 0.5% bupivacaine	①③④⑤
Çiftçi, 2020^Citation56	60	Arthroscopic Shoulder Surgery:	ESPB vs Sham block	30 mL of 0.25% bupivacaine	①③④⑤
Çiftçi, 2020^Citation57	60	Lumbar Discectomy Surgery	ESPB vs No block	20 mL of 0.25% bupivacaine	①③④⑤
Çiftçi, 2020^Citation58	60	Video-Assisted Thoracic Surgery	ESPB vs No block	20 mL of 0.25% bupivacaine	①③④⑤
Çiftçi, 2019^Citation59	60	Video-Assisted Thoracic Surgery	ESPB vs No block	20 mL of 0.25% bupivacaine	①③④⑤
Calia, 2019^Citation60	29	Open lumbar decompression surgery	ESPB vs No block	20 mL of 0.5% levobupivacaine	①
Bryniarski, 2021^Citation61	68	Percutaneous nephrolithotomy	ESPB vs No block	20 mL of 0.5% bupivacaine	①④⑤
Athar, 2021^Citation62	30	Cardiac Surgery	ESPB vs Sham block	20 mL of 0.25% levobupivacaine	①②④⑤
Altiparmak, 2019^Citation63	42	Cholecystectomy	ESPB vs Sham block	20 mL of 0.25% bupivacaine	①②③④
Aksu, 2019^Citation64	50	Breast surgery	ESPB vs No block	20 mL of 0.25% bupivacaine	①③④
Aksu, 2019^Citation65	46	Cholecystectomy	ESPB vs No block	20 mL of 0.25% bupivacaine	①③④
Abu Elyazed, 2019^Citation66	60	Open epigastric hernia repair	ESPB vs Sham block	20 mL of 0.25% bupivacaine	①②③④
Abdelhamid, 2020^Citation67	44	Sleeve gastrectomy:	ESPB vs No block	30 mL of 0.25% bupivacaine	①②③④
Abd Ellatif, 2021^Citation68	50	Open nephrectomy	ESPB vs No block	0.3–0.4 mL/kg of 0.25% bupivacaine	①②③④

Notes: ① Postoperative opioid consumption during the first 24 hours; ②Time to first rescue analgesic; ③Rescue analgesia requirement; ④ The incidence of PONV; ⑤ Adverse events.

Figure 2 A summary of bias for each included study.

Figure 3 Forest plot for subgroup analysis of the effect of ESPB on postoperative opioid consumption during the first 24 h after surgery, according to the different types of surgeries.

Figure 4 Forest plot for subgroup analysis of the effect of ESPB on postoperative opioid consumption during the first 24 h after surgery, according to the definition of the control group.

Figure 5 Forest plot for subgroup analysis of the effect of ESPB on postoperative opioid consumption during the first 24 h after surgery, different type of postoperative analgesics.

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