Analgesic efficacy of uni-level erector spinae plane block in breast cancer surgery patients: a systematic review and Meta-analysis

Abstract

Surgery remains the cornerstone of management in breast cancer patients. Regional anesthesia techniques, such as the erector spinae plane block (ESPB), have emerged as adjuncts to standard therapy for postoperative pain control. Studies comparing ESPB and standard procedure of general anesthesia and opioids were included. Primary outcomes were postoperative pain scores, analgesia duration, and postoperative morphine consumption. VAS pain scores were significantly reduced with the ESPB group. Similarly, longer analgesia duration (MD 7.03, 95%CI 4.92, 9.14, P < 0.0001), and lower postoperative morphine consumption (MD -5.77; 95% CI, -7.89, -3.65; P < 0.0001) were observed in the ESPB group. NRS pain scores at 24 h, intraoperative fentanyl, and postoperative tramadol consumption also decreased with ESPB. No significant differences were observed for NRS scores at 12 h. However, heterogeneity was high and most of the included studies had high or unclear risk of bias. ESPB may reduce opioid consumption and postoperative pain scores compared to the control groups. However, these results should be taken cautiously, due to the high risk of bias among the included studies and low certainty.