Comparison of erector spinae plane block with paravertebral block for thoracoscopic surgery: a meta-analysis of randomized controlled trials

IntroductionThe efficacy of erector spinae plane block versus paravertebral block for thoracoscopic surgery remains controversial. We conduct a systematic review and meta-analysis to explore the impact of erector spinae plane block versus paravertebral block on thoracoscopic surgery.MethodsWe have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through March 2022 for randomized controlled trials (RCTs) assessing the effect of erector spinae plane block versus paravertebral block on thoracoscopic surgery. This meta-analysis is performed using the random-effect model.ResultsSeven RCTs are included in the meta-analysis. Overall, compared with erector spinae plane block for thoracoscopic surgery, paravertebral block results in significantly reduced pain scores at 12 h (SMD = 1.12; 95% CI 0.42 to 1.81; P = 0.002) and postoperative anesthesia consumption (SMD = 1.27; 95% CI 0.30 to 2.23; P = 0.01), but these two groups have similar pain scores at 1-2 h (SMD = 1.01; 95% CI - 0.13 to 2.15; P 0.08) and 4-6 h (SMD = 0.33; 95% CI - 0.16 to 0.81; P = 0.19), as well as incidence of nausea and vomiting (OR 0.93; 95% CI 0.38 to 2.29; P = 0.88).ConclusionsParavertebral block may be better for the pain relief after thoracoscopic surgery than erector spinae plane block.

Automated summary

In thoracoscopic surgery, paravertebral block is more effective in pain relief and reducing postoperative anesthesia consumption compared to erector spinae plane block. However, the two methods show similar results in pain scores at 1-2 hours and 4-6 hours, as well as incidence of nausea and vomiting.