{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:14:09Z","timestamp":1792109649869,"version":"4.4.0"},"reference-count":48,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    The erector spinae plane block is a new regional anaesthesia technique that provides truncal anaesthesia for breast surgery. This systematic review and meta\u2010analysis was undertaken to determine if the erector spinae plane block is effective at reducing pain scores and opioid consumption after breast surgery. This study also evaluated the outcomes of erector spinae plane blocks compared with other regional blocks. PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov were searched. We included randomised controlled trials reporting the use of the erector spinae plane block in adult breast surgery. Risk of bias was assessed with the revised Cochrane risk\u2010of\u2010bias tool. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework was used to assess trial quality. Thirteen randomised controlled trials (861 patients; 418 erector spinae plane block, 215 no blocks, 228 other blocks) were included. Erector spinae plane block reduced postoperative pain compared with no block: at 0\u20102\u00a0hours (mean difference (95% CI) \u22121.63 (\u22122.97 to \u22120.29), 6 studies, 329 patients, high\u2010quality evidence, I\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a098%, p\u00a0=\u00a00.02); at 6\u00a0hours (mean difference (95% CI) \u22120.90 (\u22121.49 to \u22120.30), 5 studies, 250 patients, high\u2010quality evidence, I\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a091%, p\u00a0=\u00a00.003); at 12\u00a0hours (mean difference (95% CI) \u22120.46 (\u22120.67 to \u22120.25), 5 studies, 250 patients, high\u2010quality evidence, I\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a058%, p\u00a0&lt;\u00a00.0001); and at 24\u00a0hours (mean difference (95% CI) \u22120.50 (\u22120.70 to \u22120.30), 6 studies, 329 patients, high\u2010quality evidence, I\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a076%, p\u00a0&lt;\u00a00.00001). Compared with no block, erector spinae plane block also showed significantly lower postoperative oral morphine equivalent requirements (mean difference (95% CI) \u221221.55mg (\u221232.57 to \u221210.52), 7 studies, 429 patients, high\u2010quality evidence, I\n                    <jats:sup>2<\/jats:sup>\n                    \u00a0=\u00a099%, p\u00a0=\u00a00.0001). Separate analysis of studies comparing erector spinae plane block with pectoralis nerve block and paravertebral block showed that its analgesic efficacy was inferior to pectoralis nerve block and similar to paravertebral block. The incidence of pneumothorax was 2.6% in the paravertebral block group; there were no reports of complications of the other blocks. This review has shown that the erector spinae plane block is more effective at reducing postoperative opioid consumption and pain scores up to 24\u00a0hours compared with general anaesthesia alone. However, it was inferior to the pectoralis nerve block and its efficacy was similar to paravertebral block. Further evidence, preferably from properly blinded trials, is required to confirm these findings.\n                  <\/jats:p>","DOI":"10.1111\/anae.15164","type":"journal-article","created":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T08:56:10Z","timestamp":1593593770000},"page":"404-413","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":139,"title":["Efficacy of erector spinae plane block for analgesia in breast surgery: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"76","author":[{"given":"R. W.","family":"Leong","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology Singapore General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. S. J.","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Singapore General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. N.","family":"Wong","sequence":"additional","affiliation":[{"name":"Central Library National University of Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. H.","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Pain Medicine Singapore General Hospital Singapore"},{"name":"Department of Anaesthesiology Singapore General Hospital Singapore"},{"name":"Department of Anaesthesiology Duke\u2010NUS Graduate Medical School Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7807-9263","authenticated-orcid":false,"given":"C. W.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology Duke\u2010NUS Graduate Medical School Singapore"},{"name":"Department of Pain Medicine Singapore General Hospital Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2006.02.007"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4637.2009.00611.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.1568"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003643-201406001-00619"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(96)03064-3"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.atc.2004.11.013"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2010105817738794"},{"key":"e_1_2_6_9_1","first-page":"1341","article-title":"Anesthesia and analgesia in breast surgery: the benefits of peripheral nerve block","volume":"21","author":"Cali Cassi L","year":"2017","journal-title":"European Review for Medical and Pharmacological Sciences"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.egja.2015.08.005"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000001652"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000015423"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/ija.IJA_455_17"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.2001.2084-2.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000451"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_6_17_1","first-page":"14898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne JAC","year":"2019","journal-title":"British Medical Journal"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/2046-4053-2-81"},{"key":"e_1_2_6_19_1","unstructured":"Faculty of Pain Medicine ANZCA.Opioid calculator \u2013 A new horizon in safety 2016.http:\/\/fpm.anzca.edu.au\/documents\/opioid_calculator_app.pdf(accessed 26\/02\/2020)."},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-13"},{"key":"e_1_2_6_21_1","unstructured":"Copenhagen: The Nordic Cochrane Centre The Cochrane Collaboration. Review Manager (RevMan) 2014."},{"key":"e_1_2_6_22_1","unstructured":"RStudio Team.RStudio: Integrated Developement Environment for R.Boston MA:RStudio Inc 2015."},{"key":"e_1_2_6_23_1","unstructured":"HigginsJPT ThomasJ ChandlerJ CumpstonM LiT PageMJ WelchVA.Cochrane Handbook for Systematic Reviews of Interventions version 6.0 updated July 2019.www.training.cochrane.org\/handbook(accessed March\u2010April\/2020)."},{"key":"e_1_2_6_24_1","first-page":"132","article-title":"Analgesic effect of the bi\u2010level injection erector spinae plane block after breast surgery: a randomized controlled trial","volume":"31","author":"Aksu C","year":"2019","journal-title":"Agri"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2018.10.040"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.4103\/sja.SJA_625_19"},{"key":"e_1_2_6_27_1","first-page":"1008","article-title":"Role of erector spinae plane block versus paravertebral block in pain control after modified radical mastectomy. A prospective randomised trial. Indian Journal of","volume":"63","author":"El Ghamry MR","year":"2019","journal-title":"Anaesthesia"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.4103\/aer.AER_77_19"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.4103\/ija.IJA_536_19"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.4103\/sja.SJA_260_19"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.4103\/ija.IJA_758_18"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.4103\/ija.IJA_163_19"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2019-101013"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2019-100983"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2019.06.036"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2018.06.033"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(03)00176-3"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12630-018-1187-y"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000789"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12871-019-0700-3"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2015.10.003"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000641"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.redar.2017.08.004"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.4103\/ija.IJA_639_19"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1136\/rapm\u20102019\u2010101019"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1995.tb06148.x"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0b013e328343c569"},{"key":"e_1_2_6_48_1","unstructured":"Committee for Proprietary Medicinal Products.Note for guidance on clinical investigation of medicinal products for treatment of nociceptive pain 2002.https:\/\/www.ema.europa.eu\/en\/documents\/scientific\u2010guideline\/note\u2010guidance\u2010clinical\u2010investigation\u2010medicinal\u2010products\u2010treatment\u2010nociceptive\u2010pain_en.pdf(accessed 12\/05\/2020)."},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0b013e32834592a8"}],"container-title":["Anaesthesia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fanae.15164","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.15164","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/anae.15164","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/anae.15164","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T17:30:59Z","timestamp":1761672659000},"score":1,"resource":{"primary":{"URL":"https:\/\/associationofanaesthetists-publications.onlinelibrary.wiley.com\/doi\/10.1111\/anae.15164"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7]]},"references-count":48,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1111\/anae.15164"],"URL":"https:\/\/doi.org\/10.1111\/anae.15164","archive":["Portico"],"relation":{},"ISSN":["0003-2409","1365-2044"],"issn-type":[{"value":"0003-2409","type":"print"},{"value":"1365-2044","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7]]},"assertion":[{"value":"2020-05-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}