MTP5.07 Erector spinae block reduces postoperative pain and analgesia consumption versus alternative plane blocks 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 alternative plane blocks (APB). 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 APB. 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 7 randomized, control trials were included recruiting 414 patients who were undergoing cholecystectomy that received either ESPB or APB. In the random effect model analysis, ESPB was shown to significantly reduce pain postoperatively at 0-1 hours (Standard mean difference (SMD): -1.67, 95% confidence interval (CI): [-2.68, -0.67], Z=3.26, P=0.001), 2 hours (SMD: -1.16, 95% CI: [-1.96, -0.36], Z=2.84, P=0.004), 6 hours (SMD: -1.03, 95% CI: [-1.4, -0.65], Z=5.35, P<0.00001), and 24 hours (SMD: -1.84, 95% CI: [-3.53, -0.15], Z=2.13, P=0.03). Furthermore, postoperative opioid consumption was significantly lower in patients who received ESPB (SMD: -0.96, 95%CI: [-1.8, -0.11], Z=2.22, P=0.03). No statistical difference in pain was observed 12 hours postoperatively (SMD: -0.52, 95% CI: [-1.56, -0.52], Z=0.98, P=0.32). Conclusion ESPB was shown to be more effective at reducing postoperative pain and analgesia consumption in patients undergoing laparoscopic cholecystectomy.