{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T02:03:03Z","timestamp":1773108183394,"version":"3.50.1"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T00:00:00Z","timestamp":1656892800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012632","name":"Nazarbayev University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012632","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Neurosurgical spinal surgeries such as micro- discectomy and complex fusion surgeries remain the leading causes of disability-adjusted life-year. Major spinal surgeries often result in severe postprocedural pain due to massive dissection of the underlying tissues. While opioids offer effective pain control, they frequently lead to side effects, such as post-operative nausea and vomiting, pruritus, constipation, and respiratory depression. ESPB was successfully used in spinal surgery as a component of a multimodal analgesic regimen and it eliminated the requirements for opioids. The primary purpose of this systematic review and meta-analysis was to compare post-operative opioid consumption between ESPB and placebo.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>To conduct this systematic review, we used the \u201cPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)\u201d guidelines. We conducted a search for relevant articles available in the following databases: Google Scholar, PubMed, and the Cochrane Library published up to March 2022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The total morphine consumption within 24 h after surgery was lower in the ESPB group, the mean difference (in mg of morphine) with 95% CI is \u22129.27 (\u221211.63, \u22126.91). The pain intensity (0\u201310) at rest measured 24 h after surgery was lower in the ESPB group, the MD with 95% CI is \u22120.47 (\u22120.77, \u22120.17). The pain intensity during movement measured 24 h after surgery was lower in the ESPB group, the MD with 95% CI is \u22120.73 (\u22121.00, \u22120.47). Post-operative nausea and vomiting were significantly lower in the ESPB group, the risk ratio with 95% CI is 0.32 (0.19, 0.53).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ultrasound-guided ESPB was superior to placebo in reducing post-operative opioid consumption, pain intensity, post-operative nausea and vomiting, and prolonging the time to first rescue analgesia. There were no ESPB-related serious complications reported.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2022.932101","type":"journal-article","created":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T07:50:47Z","timestamp":1656921047000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Ultrasound-Guided Erector Spinae Plane Block in Thoracolumbar Spinal Surgery: A Systematic Review and Meta-Analysis"],"prefix":"10.3389","volume":"9","author":[{"given":"Dmitriy","family":"Viderman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina","family":"Aubakirova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yerlan","family":"Umbetzhanov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gulnara","family":"Kulkaeva","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. B.","family":"Shalekenov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yerkin G.","family":"Abdildin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1686","DOI":"10.1213\/ANE.0b013e3181cbd9cc","article-title":"What will anesthesiologists be anesthetizing? Trends in neurosurgical procedure usage.","volume":"110","author":"Hughey","year":"2010","journal-title":"Anesth Analg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1056\/NEJMra1201534","article-title":"Measuring the global burden of disease.","volume":"369","author":"Murray","year":"2013","journal-title":"N Engl J Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1016\/j.jocn.2015.01.003","article-title":"Best evidence in multimodal pain management in spine surgery and means of assessing postoperative pain and functional outcomes.","volume":"22","author":"Devin","year":"2015","journal-title":"J Clin Neurosci."},{"key":"B4","first-page":"S105","article-title":"Opioid complications and side effects.","volume":"11","author":"Ricardo Buenaventura","year":"2008","journal-title":"Pain Physician."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1998","DOI":"10.21037\/jtd.2018.02.48","article-title":"The role of local anaesthetic techniques in ERAS protocols for thoracic surgery.","volume":"10","author":"Crumley","year":"2018","journal-title":"J Thorac Dis."},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1515\/sjpain-2020-0171","article-title":"Erector spinae plane block in acute interventional pain management: a systematic review.","volume":"2021","author":"Viderman","year":"2021","journal-title":"Scand J Pain."},{"key":"B7","doi-asserted-by":"publisher","first-page":"458","DOI":"10.1177\/0300891620985935","article-title":"Erector spinae plane block in chronic pain management: a scoping review.","volume":"107","author":"Viderman","year":"2021","journal-title":"Tumori."},{"key":"B8","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1111\/anae.15164","article-title":"Efficacy of erector spinae plane block for analgesia in breast surgery: a systematic review and meta-analysis.","volume":"76","author":"Leong","year":"2021","journal-title":"Anaesthesia."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S182128","article-title":"Efficacy of bilateral erector spinae plane block in the management of pain: current insights.","volume":"12","author":"Tulgar","year":"2019","journal-title":"J Pain Res."},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.812531","article-title":"Erector spinae plane block in abdominal surgery: a meta-analysis.","volume":"9","author":"Viderman","year":"2022","journal-title":"Front Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"308","DOI":"10.23736\/S0375-9393.18.13341-4","article-title":"Erector spinae plane block: a systematic qualitative review.","volume":"85","author":"De Cassai","year":"2019","journal-title":"Minerva Anestesiol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1007\/s12630-021-02183-z","article-title":"Efficacy of regional anesthesia techniques for postoperative analgesia in patients undergoing major oncologic breast surgeries: a systematic review and network meta-analysis of randomized controlled trials.","volume":"69","author":"Singh","year":"2022","journal-title":"Can J Anesthes."},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.802039","article-title":"Transversus abdominis plane block in colorectal surgery: a meta-analysis.","volume":"8","author":"Viderman","year":"2021","journal-title":"Front Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"e849","DOI":"10.1016\/j.wneu.2020.09.077","article-title":"Ultrasound-guided erector spinae plane block versus modified-thoracolumbar interfascial plane block for lumbar discectomy surgery: a randomized, controlled study.","volume":"144","author":"Ciftci","year":"2020","journal-title":"World Neurosurg."},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2020.110090","article-title":"Bilateral ultrasound-guided erector spinae plane block in patients undergoing lumbar spinal fusion: a randomized controlled trial.","volume":"68","author":"Zhang","year":"2021","journal-title":"J Clin Anesth."},{"key":"B16","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijsu.2021.105906","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.","volume":"88","author":"Page","year":"2021","journal-title":"Int J Surg."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1177\/0962280216669183","article-title":"Optimally estimating the sample mean from the sample size, median, mid-range, and\/or mid-quartile range.","volume":"27","author":"Luo","year":"2018","journal-title":"Stat Methods Med Res."},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-135","article-title":"Estimating the sample mean and standard deviation from the sample size, median, range and\/or interquartile range.","volume":"14","author":"Wan","year":"2014","journal-title":"BMC Med Res Methodol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1016\/j.jpainsymman.2009.06.001","article-title":"Opioid rotation: the science and the limitations of the equianalgesic dose table.","volume":"38","author":"Knotkova","year":"2009","journal-title":"J Pain Sympt Manage."},{"key":"B20","doi-asserted-by":"publisher","first-page":"15","DOI":"10.2147\/LRA.S143618","article-title":"Remifentanil-induced postoperative hyperalgesia: current perspectives on mechanisms and therapeutic strategies.","volume":"11","author":"Santonocito","year":"2018","journal-title":"Local Reg Anesth."},{"key":"B21","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1007\/s00540-021-02920-0","article-title":"Erector spinae block for postoperative pain management in lumbar disc hernia repair.","volume":"35","author":"Y\u00f6r\u00fcko\u011flu","year":"2021","journal-title":"J Anesth."},{"key":"B22","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1097\/ANA.0000000000000603","article-title":"Bilateral ultrasound-guided erector spinae plane block for postoperative analgesia in lumbar spine surgery: a randomized control trial.","volume":"32","author":"Singh","year":"2020","journal-title":"J Neurosurg Anesthesiol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"E902","DOI":"10.1097\/BRS.0000000000003966","article-title":"The efficacy of intraoperative freehand erector spinae plane block in lumbar spondylolisthesis: a randomized controlled study.","volume":"46","author":"Ye\u015filta\u015f","year":"2021","journal-title":"Spine."},{"key":"B24","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.wneu.2020.10.175","article-title":"The analgesic efficacy of erector spinae plane blocks in patients undergoing posterior lumbar spinal surgery for lumbar fracture.","volume":"147","author":"Yu","year":"2021","journal-title":"World Neurosurg."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1873","DOI":"10.1016\/j.spinee.2021.06.015","article-title":"Clinical efficacy of ultrasound guided bilateral erector spinae block for single level lumbar fusion surgery: a prospective, randomized, case-control study.","volume":"21","author":"Goel","year":"2021","journal-title":"Spine J."},{"key":"B26","doi-asserted-by":"publisher","first-page":"e779","DOI":"10.1016\/j.wneu.2019.02.149","article-title":"Postoperative analgesic efficacy of the ultrasound-guided erector spinae plane block in patients undergoing lumbar spinal decompression surgery: a randomized controlled study.","volume":"126","author":"Yayik","year":"2019","journal-title":"World Neurosurg."},{"key":"B27","doi-asserted-by":"publisher","first-page":"1499","DOI":"10.1111\/anae.15488","article-title":"A randomised trial of bilateral erector spinae plane block vs. no block for thoracolumbar decompressive spinal surgery.","volume":"76","author":"Finnerty","year":"2021","journal-title":"Anaesthesia."},{"key":"B28","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1007\/s00101-020-00848-w","article-title":"Ultrasound-guided erector spinae block versus mid-transverse process to pleura block for postoperative analgesia in lumbar spinal surgery.","volume":"69","author":"Eskin","year":"2020","journal-title":"Anaesthesist."},{"key":"B29","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1227\/01.NEU.0000337574.58662.E2","article-title":"Recurrent disc herniation and long-term back pain after primary lumbar discectomy: review of outcomes reported for limited versus aggressive disc removal.","volume":"64","author":"McGirt","year":"2009","journal-title":"Neurosurgery."},{"key":"B30","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1097\/AAP.0b013e3182340869","article-title":"Beyond opioid patient-controlled analgesia: a systematic review of analgesia after major spine surgery.","volume":"37","author":"Sharma","year":"2012","journal-title":"Reg Anesthes Pain Med."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1111\/anae.14408","article-title":"Comparison of injectate spread and nerve involvement between retrolaminar and erector spinae plane blocks in the thoracic region: a cadaveric study.","volume":"73","author":"Yang","year":"2018","journal-title":"Anaesthesia."},{"key":"B32","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1111\/anae.14523","article-title":"Injectate spread in erector spinae plane block.","volume":"74","author":"Greenhalgh","year":"2019","journal-title":"Anaesthesia."},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2019-100514","article-title":"Is high volume lumbar erector spinae plane block an alternative to transforaminal epidural injection? Evaluation with MRI.","author":"Celik","year":"2019","journal-title":"Reg Anesth Pain Med."},{"key":"B34","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1136\/rapm-2020-101718","article-title":"Pharmacokinetics of lidocaine after bilateral ESP block.","volume":"46","author":"De Cassai","year":"2021","journal-title":"Reg Anesthes Pain Med."},{"key":"B35","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1016\/j.redar.2018.07.004","article-title":"Erector spinae plane block: a cadaver study to determine its mechanism of action.","volume":"65","author":"Vidal","year":"2018","journal-title":"Rev Espa\u00f1ola Anestesiol."},{"key":"B36","doi-asserted-by":"publisher","first-page":"756","DOI":"10.1097\/AAP.0000000000000798","article-title":"Erector spinae plane block versus retrolaminar block: a magnetic resonance imaging and anatomical study.","volume":"43","author":"Adhikary","year":"2018","journal-title":"Reg Anesth Pain Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1097\/ACO.0b013e32830815d1","article-title":"Ultrasound-guided peripheral nerve blockade.","volume":"21","author":"Chin","year":"2008","journal-title":"Curr Opin Anaesthesiol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1016\/j.redar.2020.10.009","article-title":"Analysis of bupivacaine and ropivacaine-related cardiac arrests in regional anesthesia: a systematic review of case reports.","volume":"68","author":"Viderman","year":"2021","journal-title":"Rev Esp Anestesiol Reanim."},{"key":"B39","article-title":"Changes of opioid consumption after lumbar fusion using ultrasound-guided lumbar erector spinae plane block: a randomized controlled trial.","volume":"24","author":"Zhu","year":"2021","journal-title":"Pain Phys"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.932101\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T07:50:53Z","timestamp":1656921053000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2022.932101\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,4]]},"references-count":39,"alternative-id":["10.3389\/fmed.2022.932101"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2022.932101","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,4]]},"article-number":"932101"}}