• Wenzhu Wang, Weilin Yang, Ang Liu, Jian Liu, and Changxiu Yuan.
• Department of Anesthesiology, Jining No. 1 People's Hospital, Jining, Shandong, China.
• J. Cardiothorac. Vasc. Anesth. 2024 Nov 1; 38 (11): 279228002792-2800.

ObjectivesTo assess the analgesic effect of erector spinae plane block in adults undergoing median sternotomy cardiac surgery.Design And SettingThe Cochrane, Embase, and PubMed databases from inception to January 2024 were searched. The study has been registered in the International Prospective Register of Systematic Reviews (CRD42023470375).ParticipantsEight randomized controlled trials involving 543 patients, comparing with no block or sham block, were included, whether it was a single injection or continuous.Measurements And Main ResultsThe primary outcomes were pain scores and opioid consumption. Erector spinae plane block reduced pain scores immediately after extubation (mean difference [MD], -1.19; 95% confidence interval [CI], -1.67 to -0.71; p for heterogeneity = 0.10), at 6 hours after extubation (MD, -1.96; 95% CI, -2.85 to -1.08; p for heterogeneity < 0.0001), and at 12 hours after extubation (MD, -0.98; 95% CI, -1.55 to -0.40; p for heterogeneity < 0.00001). The decrease in pain scores reached the minimal clinically important difference within 6 hours. Opioid consumption 24 hours after surgery decreased by 35.72 mg of oral morphine equivalents (95% CI, -50.88 to -20.57; p for heterogeneity < 0.0001). Sensitivity analysis confirmed the stability of results. The quality of primary outcomes was rated as very low to moderate.ConclusionsErector spinae plane block decreased pain scores within 12 hours after extubation, reached the minimal clinically important difference within 6 hours, and decreased opioid consumption 24 hours after surgery, based on data of very low to moderate quality. However, high-quality randomized controlled trials are necessary to validate these findings.Copyright © 2024 Elsevier Inc. All rights reserved.

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