Key result
Erector spinae plane block reduces 24-hour opioid consumption vs placebo after total hip arthroplasty.
Why the study?
The effectiveness and pain-relief capabilities of erector spinae plane block in total hip arthroplasty have not been definitively established.
Does Erector Spinae Plane Block reduce postoperative opioid consumption and pain in patients undergoing total hip arthroplasty?
Meta-Analysis (n=299)
Does Erector Spinae Plane Block reduce postoperative opioid consumption and pain in patients undergoing total hip arthroplasty?
Effect estimate: mean difference -4.29 (95% CI -5.33 to -3.25)
p-value: p=< 0.00001
Ultrasound-guided ESPB significantly reduces postoperative opioid consumption at 24 hours following total hip arthroplasty, despite no significant difference in pain scores.
Supports ESPB for opioid reduction in THA multimodal regimens; extends limited prior RCTs with pooled Level 1 data.
Purpose. The Erector Spinae Plane Block (ESPB) is a widely used regional anesthesia technique in breast, thoracic, and spine surgery. However, its effectiveness and pain-relief capabilities in total hip arthroplasty have not been definitively established. This meta-analysis seeks to establish the analgesic effectiveness of ESPB in total hip arthroplasty. Methods. As per PRISMA guidelines, we carried out a meta-analysis of prospective randomized clinical trials that compared the effects of ESPB in the control group and different peripheral nerve blocks in total hip arthroplasty. The study was registered in the International Register of Systematic Reviews (PROSPERO) and can be accessed online (www.crd.york.uk/prospero, CRD42024498350). Results. Six studies involving 299 participants were critically evaluated and included for analysis. The results showed that ultrasound-guided ESPB led to a decrease in postoperative opioid consumption 24 hours after surgery compared to a placebo (mean difference –4.29, 95% CI –5.33 to –3.25; p < 0.00001). However, there were no significant differences in postoperative pain scores at Department of Palliative Medicine, Poznan University of Medical Sciences, Poznań, Poland 3-6 hours and 24 hours between the two groups. Conclusion. ESPB improved the effectiveness of pain relief in total hip arthroplasty, particularly without nerve block analgesia. More high-quality, well-defined RCTs are urgently required to assess the pros and cons of ESPB for total hip arthroplasty.
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Reysner et al. (2024) conducted a meta-analysis in total hip arthroplasty (n=299). Erector Spinae Plane Block (ESPB) vs. placebo was evaluated on postoperative opioid consumption 24 hours after surgery (mean difference -4.29, 95% CI -5.33 to -3.25, p=< 0.00001). Erector Spinae Plane Block significantly decreased postoperative opioid consumption 24 hours after total hip arthroplasty compared to placebo (mean difference -4.29; 95% CI -5.33 to -3.25; p<0.00001).
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