MTP5.03 Erector spinae block versus placebo or control in patients undergoing laparoscopic cholecystectomy: a systematic review and meta-analysis

Introduction The objective of this study is to compare postoperative pain and analgesic consumption between patients undergoing laparoscopic cholecystectomy who receive erector spinae plane blocks (ESPB) and those receiving standard analgesia. Methods Standard medical databases such as MEDLINE, Embase, Pubmed, and Cochrane Library were searched to find randomized controlled trials comparing postoperative pain and analgesia consumption between patients undergoing laparoscopic cholecystectomy who received ESPB and those receiving standard analgesia. All data were analyzed using Review Manager Software 5.4, and the meta-analysis was performed with a random effect model analysis. Results A total of 12 randomized, control trials were included recruiting 707 patients who were undergoing cholecystectomy that received either ESPB or standard analgesia. In the random effect model analysis, ESPB was found to significantly reduce postoperative opioid consumption (Standard mean difference [SMD]: -2.24, 95% confidence interval [CI]: [-3.01, -1.46], Z = 5.68, P < 0.00001), as well as 0–2-hour postoperative pain (SMD: -1.18, 95% CI: [-2.23, -0.13], Z = 2.2, P = 0.03). ESPB, however, failed to significantly reduce pain at 12 hours (SMD: 0.00, 95% CI: [-1.47, 1.48], Z = 0.00, P = 1.00) and 24 hours (SMD: -0.53, 95% CI: [-1.10, -1.46], Z = 1.83, P = 0.07). Conclusion ESPB significantly reduces pain in the early postoperative period and overall analgesia consumption in patients undergoing laparoscopic cholecystectomy.