Analgesic comparison of erector spinae plane block with intercostal nerve block for thoracoscopic surgery: A meta-analysis of randomized controlled trials

Abstract

Introduction: The analgesic efficacy of erector spinae plane block (ESPB) versus intercostal nerve block (ICNB) for thoracoscopic surgery remains controversial. We conducted a systematic review and meta-analysis to explore the impact of ESPB versus ICNB on thoracoscopic surgery. Methods: We searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane library databases through May 2023 for randomized controlled trials (RCTs) assessing the effect of ESPB versus ICNB on thoracoscopic surgery. This meta-analysis was performed using the random-effect model or fixed-effect model based on the heterogeneity. Results: Four RCTs and 203 patients are included in the meta-analysis. Overall, compared with ICNB for thoracoscopic surgery, ESPB results in significantly reduced pain scores at 48 hours (SMD [standard mean difference] = −3.49; 95% CI [confidence interval] = −6.76 to −0.21; P = .04), but demonstrated no impact on pain scores at 24 hours (SMD = −0.04; 95% CI = −1.24 to 1.16; P = .95), pain scores at 4 to 6 hours (SMD = −0.16; 95% CI = −2.02 to 1.71; P = .87), pain scores at 12 hours (SMD = −0.16; 95% CI = −2.38 to 2.05; P = .88) or analgesic consumption (SMD = 0.27; 95% CI = −0.80 to 1.35; P = .62). Conclusions: ESPB may be comparable with ICNB for the postoperative pain control of thoracoscopic surgery.