Comparison of efficacy of ultrasound-guided erector spinae plane block versus thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries: A systematic review and trial sequential meta-analysis
Background and Aims: Existing literature does not establish the superiority of the erector spinae plane (ESP) block or the thoracolumbar interfascial plane (TLIP) block in pain relief and reducing opioid consumption in lumbar spine surgeries. This systematic review and meta-analysis was aimed to dis...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-09-01
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| Series: | Indian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/ija.ija_373_24 |
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| author | Siddhavivek Majage Rajathadri Hosur Ravikumar Mrudula Prasanna M Chandramouli Priyankar Kumar Datta Dalim Kumar Baidya |
| author_facet | Siddhavivek Majage Rajathadri Hosur Ravikumar Mrudula Prasanna M Chandramouli Priyankar Kumar Datta Dalim Kumar Baidya |
| author_sort | Siddhavivek Majage |
| collection | DOAJ |
| description | Background and Aims:
Existing literature does not establish the superiority of the erector spinae plane (ESP) block or the thoracolumbar interfascial plane (TLIP) block in pain relief and reducing opioid consumption in lumbar spine surgeries. This systematic review and meta-analysis was aimed to discern their relative efficacy and safety.
Methods:
This meta-analysis included randomised controlled trials (RCTs) comparing ESP and TLIP blocks in lumbar spine surgeries. The primary outcome was 24-h opioid consumption, and secondary outcomes were visual analogue scale (VAS) scores at 1 h and 24 h and various complications. PubMed, Central Register of Controlled Trials, SCOPUS, EMBASE databases and cross-references were electronically searched. Two authors extracted data independently, cross-checked, and analysed them using RevMan 5.4. Binary outcomes were reported as odds ratios (OR), while continuous outcomes were presented as standardised mean differences (SMDs) accompanied by 95% confidence intervals (95% CIs).
Results:
Among 1107 articles, six RCTs (492 patients) were finally included. The ESP block demonstrated lower 24-h opioid consumption compared to TLIP [SMD -0.32 (95% CI: -0.50, -0.14); P < 0.001, I2 = 83%]. At 1 and 24 h, ESPB yielded significantly lower VAS scores compared to TLIP [1 h: SMD -0.38 (95% CI: -0.57, -0.18); P < 0.001, I2 = 83%; 24 h: SMD -0.57 (95% CI: -0.76, -0.37); P < 0.001, I2 = 73%]. No significant difference was noted in adverse events.
Conclusion:
In comparison to the TLIP block, the ESP block has significantly lower 24-h opioid consumption and VAS scores at 1 and 24 h in patients undergoing lumbar spine surgery. |
| format | Article |
| id | doaj-art-bf209ff5bd5c4a4dbc4a34d938700fe0 |
| institution | Kabale University |
| issn | 0019-5049 0976-2817 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj-art-bf209ff5bd5c4a4dbc4a34d938700fe02025-01-23T09:22:30ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-28172024-09-0168975276110.4103/ija.ija_373_24Comparison of efficacy of ultrasound-guided erector spinae plane block versus thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries: A systematic review and trial sequential meta-analysisSiddhavivek MajageRajathadri Hosur RavikumarMrudula PrasannaM ChandramouliPriyankar Kumar DattaDalim Kumar BaidyaBackground and Aims: Existing literature does not establish the superiority of the erector spinae plane (ESP) block or the thoracolumbar interfascial plane (TLIP) block in pain relief and reducing opioid consumption in lumbar spine surgeries. This systematic review and meta-analysis was aimed to discern their relative efficacy and safety. Methods: This meta-analysis included randomised controlled trials (RCTs) comparing ESP and TLIP blocks in lumbar spine surgeries. The primary outcome was 24-h opioid consumption, and secondary outcomes were visual analogue scale (VAS) scores at 1 h and 24 h and various complications. PubMed, Central Register of Controlled Trials, SCOPUS, EMBASE databases and cross-references were electronically searched. Two authors extracted data independently, cross-checked, and analysed them using RevMan 5.4. Binary outcomes were reported as odds ratios (OR), while continuous outcomes were presented as standardised mean differences (SMDs) accompanied by 95% confidence intervals (95% CIs). Results: Among 1107 articles, six RCTs (492 patients) were finally included. The ESP block demonstrated lower 24-h opioid consumption compared to TLIP [SMD -0.32 (95% CI: -0.50, -0.14); P < 0.001, I2 = 83%]. At 1 and 24 h, ESPB yielded significantly lower VAS scores compared to TLIP [1 h: SMD -0.38 (95% CI: -0.57, -0.18); P < 0.001, I2 = 83%; 24 h: SMD -0.57 (95% CI: -0.76, -0.37); P < 0.001, I2 = 73%]. No significant difference was noted in adverse events. Conclusion: In comparison to the TLIP block, the ESP block has significantly lower 24-h opioid consumption and VAS scores at 1 and 24 h in patients undergoing lumbar spine surgery.https://journals.lww.com/10.4103/ija.ija_373_24erector spinae plane blocklumbar surgeryopioid-free analgesiaregional analgesiaspine surgerythoracolumbar interfascial plane blocktrial sequential meta-analysisultrasound-guided blocks |
| spellingShingle | Siddhavivek Majage Rajathadri Hosur Ravikumar Mrudula Prasanna M Chandramouli Priyankar Kumar Datta Dalim Kumar Baidya Comparison of efficacy of ultrasound-guided erector spinae plane block versus thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries: A systematic review and trial sequential meta-analysis Indian Journal of Anaesthesia erector spinae plane block lumbar surgery opioid-free analgesia regional analgesia spine surgery thoracolumbar interfascial plane block trial sequential meta-analysis ultrasound-guided blocks |
| title | Comparison of efficacy of ultrasound-guided erector spinae plane block versus thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries: A systematic review and trial sequential meta-analysis |
| title_full | Comparison of efficacy of ultrasound-guided erector spinae plane block versus thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries: A systematic review and trial sequential meta-analysis |
| title_fullStr | Comparison of efficacy of ultrasound-guided erector spinae plane block versus thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries: A systematic review and trial sequential meta-analysis |
| title_full_unstemmed | Comparison of efficacy of ultrasound-guided erector spinae plane block versus thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries: A systematic review and trial sequential meta-analysis |
| title_short | Comparison of efficacy of ultrasound-guided erector spinae plane block versus thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries: A systematic review and trial sequential meta-analysis |
| title_sort | comparison of efficacy of ultrasound guided erector spinae plane block versus thoracolumbar interfascial plane block in patients undergoing lumbar spine surgeries a systematic review and trial sequential meta analysis |
| topic | erector spinae plane block lumbar surgery opioid-free analgesia regional analgesia spine surgery thoracolumbar interfascial plane block trial sequential meta-analysis ultrasound-guided blocks |
| url | https://journals.lww.com/10.4103/ija.ija_373_24 |
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