{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T13:41:47Z","timestamp":1765806107565,"version":"3.48.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Background<\/jats:title>\n Whether the erector spinae plane block (ESPB) truly relieves pain after arthroscopic shoulder surgery (ASS) is still unsettled. We therefore examined whether ESPB sharpens post-operative pain control in these patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We systematically searched the Cochrane Library, PubMed, Embase, and Web of Science for randomized controlled trials (RCTs) comparing ESPB with any comparator (no block, sham block, or alternative regional block) in patients undergoing ASS. The primary outcome was cumulative opioid consumption within the first 24\u202fh postoperatively. Secondary outcomes included pain scores at rest and during movement, incidence of postoperative nausea and vomiting (PONV), time to first rescue analgesic request, and patient-reported satisfaction with analgesia.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Six RCTs comprised of 365 patients met inclusion criteria. ESPB did not reduce 24-h opioid consumption versus control (SMD \u22121.11; 95% CI \u22122.55 to 0.33;\n p<\/jats:italic>\n \u202f=\u202f0.13,\n I<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f96%). Pain scores were lower with ESPB at 2\u202fh (SMD \u22120.83; 95% CI \u22121.30 to \u22120.37;\n p<\/jats:italic>\n \u202f=\u202f0.0005,\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f35%) and 48\u202fh (SMD \u22120.64; 95% CI \u22121.08 to \u22120.20;\n p<\/jats:italic>\n \u202f=\u202f0.004,\n I<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f95%), but not at 4\u202fh. Furthermore, time to first rescue analgesic was prolonged by ESPB (SMD 4.04; 95% CI 0.77\u20137.31;\n p<\/jats:italic>\n \u202f=\u202f0.02,\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f99%). However, ESPB did not reduce the rest and movement pain scores at 2\u202fh (SMD \u22120.87; 95% CI \u22122.98 to 1.24;\n p<\/jats:italic>\n \u202f=\u202f0.42;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f97%; SMD \u22120.98; 95% CI \u22123.00 to 1.04;\n p<\/jats:italic>\n \u202f=\u202f0.34;\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f97%) and 4\u202fh (SMD \u22120.43; 95% CI \u22122.31 to 1.46;\n p<\/jats:italic>\n \u202f=\u202f0.66;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f97%; SMD \u22120.89; 95% CI \u22122.57 to 0.80;\n p<\/jats:italic>\n \u202f=\u202f0.30;\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f96%), respectively. PONV and other adverse events were comparable. Subgroup analysis of single-injection ESPB also showed no opioid-sparing effect (SMD \u22121.46; 95% CI \u22123.21 to 0.30;\n p<\/jats:italic>\n \u202f=\u202f0.10,\n I<\/jats:italic>\n 2<\/jats:sup>\n =\u202f97%). Patient-reported satisfaction revealed no significant difference between ESPB and control group.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The ESPB fails to reduce 24-h opioid consumption, pain scores at rest and movement at early stage, and the incidence of PONV. Nevertheless, it prolonged the time to first rescue analgesic without elevating the risk of adverse events.<\/jats:p>\n <\/jats:sec>\n \n Systematic review registration<\/jats:title>\n \n PROSPERO, registration number CRD 42023395027,\n https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42023395027<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2025.1702898","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T18:10:49Z","timestamp":1765563049000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Analgesic efficacy of erector spinae plane block for managing pain in arthroscopic shoulder surgery: a systemic review and meta-analysis"],"prefix":"10.3389","volume":"12","author":[{"given":"Ying","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiuya","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen","family":"Jie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fenglin","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"189","DOI":"10.36076\/ppj.2009\/12\/189","article-title":"Continuous cervical epidural analgesia for rehabilitation after shoulder surgery: a retrospective evaluation","volume":"12","author":"Narouze","year":"2009","journal-title":"Pain Physician"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.1097\/00000539-199706000-00024","article-title":"Suprascapular nerve block for postoperative pain relief in arthroscopic shoulder surgery: a new modality?","volume":"84","author":"Ritchie","year":"1997","journal-title":"Anesth Analg"},{"key":"ref3","first-page":"577","article-title":"Comparison of erector spinae plane block at the level of the second thoracic vertebra with suprascapular nerve block for postoperative analgesia in arthroscopic shoulder surgery","volume":"25","author":"Abdelhaleem","year":"2022","journal-title":"Pain Physician"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1007\/s12630-017-1010-1","article-title":"Erector spinae plane block for the management of chronic shoulder pain: a case report. Bloc du plan des muscles \u00e9recteurs du rachis pour la prise en charge de la douleur chronique \u00e0 l\u2019\u00e9paule: une pr\u00e9sentation de cas","volume":"65","author":"Forero","year":"2018","journal-title":"Can J Anaesth"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"109900","DOI":"10.1016\/j.jclinane.2020.109900","article-title":"Erector spinae plane block for postoperative analgesia in breast and thoracic surgery: a systematic review and meta-analysis","volume":"66","author":"Huang","year":"2020","journal-title":"J Clin Anesth"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"368","DOI":"10.1053\/j.jvca.2018.05.050","article-title":"Bilateral erector spinae plane block for acute post-surgical pain in adult cardiac surgical patients: a randomized controlled trial","volume":"33","author":"Krishna","year":"2019","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1016\/j.bja.2022.05.013","article-title":"Ultrasound-guided erector spinae plane block improves analgesia after laparoscopic hepatectomy: a randomised controlled trial","volume":"129","author":"Huang","year":"2022","journal-title":"Br J Anaesth"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"106689","DOI":"10.1016\/j.ijsu.2022.106689","article-title":"Ultrasound-guided erector spinae plane block for postoperative analgesia in patients after liver surgery: a systematic review and meta-analysis on randomized comparative studies","volume":"103","author":"Bhushan","year":"2022","journal-title":"Int J Surg"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"110647","DOI":"10.1016\/j.jclinane.2022.110647","article-title":"Analgesic efficacy of erector spinae plane block in lumbar spine surgery: a systematic review and meta-analysis","volume":"78","author":"Oh","year":"2022","journal-title":"J Clin Anesth"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"110153","DOI":"10.1016\/j.jclinane.2020.110153","article-title":"Erector spinae plane block combined with local infiltration analgesia for total hip arthroplasty: a randomized, placebo controlled, clinical trial","volume":"69","author":"Lennon","year":"2021","journal-title":"J Clin Anesth"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1080\/11101849.2021.1995280","article-title":"Erector spinae plane block versus intraarticular injection of local anesthetic for postoperative analgesia in patients undergoing shoulder arthroscopy: a randomized controlled study","volume":"37","author":"Abdelraheem","year":"2021","journal-title":"Egypt J Anaesth"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1093\/pm\/pnaa359","article-title":"High thoracic erector spinae plane block for arthroscopic shoulder surgery: a randomized prospective double-blind study","volume":"22","author":"Ciftci","year":"2021","journal-title":"Pain Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"105906","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":"ref14","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/1471-2288-5-13","article-title":"Estimating the mean and variance from the median, range, and the size of a sample","volume":"5","author":"Hozo","year":"2005","journal-title":"BMC Med Res Methodol"},{"key":"ref15","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":"ref16","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1002\/pds.3945","article-title":"A synthesis of oral morphine equivalents (OME) for opioid utilisation studies","volume":"25","author":"Nielsen","year":"2016","journal-title":"Pharmacoepidemiol Drug Saf"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"20225367","DOI":"10.1101\/2020.11.03.20225367","article-title":"A comparison of pain registration by visual analog scale and numeric rating scale \u2013 a cross-sectional study of primary triage registration","author":"Kollltveit","year":"2020","journal-title":"medRxiv"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"d5928","DOI":"10.1136\/bmj.d5928","article-title":"The cochrane collaboration's tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.jclinepi.2010.04.026","article-title":"GRADE guidelines: 1. Introduction-GRADE evidence profiles and summary of findings tables","volume":"64","author":"Guyatt","year":"2011","journal-title":"J Clin Epidemiol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1136\/bmj.327.7414.557","article-title":"Measuring inconsistency in meta-analyses","volume":"327","author":"Higgins","year":"2003","journal-title":"BMJ"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1002\/jrsm.1260","article-title":"Introduction, comparison, and validation of Meta-essentials: a free and simple tool for meta-analysis","volume":"8","author":"Suurmond","year":"2017","journal-title":"Res Synth Methods"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1186\/s12871-022-01687-5","article-title":"Erector spinae plane block vs interscalene brachial plexus block for postoperative analgesia management in patients who underwent shoulder arthroscopy","volume":"22","author":"Kapukaya","year":"2022","journal-title":"BMC Anesthesiol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1111\/anae.15625","article-title":"Erector spinae plane block vs. peri-articular injection for pain control after arthroscopic shoulder surgery: a randomised controlled trial","volume":"77","author":"Shanthanna","year":"2022","journal-title":"Anaesthesia"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1007\/s12630-022-02216-1","article-title":"Continuous interscalene versus phrenic nerve-sparing high-thoracic erector spinae plane block for total shoulder arthroplasty: a randomized controlled trial","volume":"69","author":"Sun","year":"2022","journal-title":"Can J Anaesth"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1007\/s12630-020-01875-2","article-title":"Mechanisms of action of the erector spinae plane (ESP) block: a narrative review","volume":"68","author":"Chin","year":"2021","journal-title":"Can J Anaesth"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"110063","DOI":"10.1016\/j.jclinane.2020.110063","article-title":"Erector spinae plane block: a narrative review with systematic analysis of the evidence pertaining to clinical indications and alternative truncal blocks","volume":"68","author":"Saadawi","year":"2021","journal-title":"J Clin Anesth"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1007\/s12630-020-01580-0","article-title":"Potential mechanism for bilateral sensory effects after a unilateral erector spinae plane block","volume":"67","author":"Elkoundi","year":"2020","journal-title":"Can J Anaesth"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1029","DOI":"10.1016\/j.bja.2021.01.021","article-title":"Minimal clinically important differences in randomised clinical trials on pain management after total hip and knee arthroplasty: a systematic review","volume":"126","author":"Laigaard","year":"2021","journal-title":"Br J Anaesth"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/s40272-020-00424-0","article-title":"Postoperative nausea and vomiting in pediatric patients","volume":"23","author":"Kovac","year":"2021","journal-title":"Paediatr Drugs"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"652","DOI":"10.1097\/00000539-199909000-00022","article-title":"Which clinical anesthesia outcomes are important to avoid? The perspective of patients","volume":"89","author":"Macario","year":"1999","journal-title":"Anesth Analg"},{"key":"ref31","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":"ref32","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1136\/rapm-2018-100360","article-title":"Leaning tower of Pisa? Avoiding a major neurologic complication with the erector spinae plane block","volume":"44","author":"Missair","year":"2019","journal-title":"Reg Anesth Pain Med"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1016\/j.redar.2018.05.009","article-title":"Ultrasound guided erector spinae plane block as a cause of unintended motor block. Bloqueo en el plano del erector de la columna ecoguiado como causa de bloqueo motor imprevisto","volume":"65","author":"Selvi","year":"2018","journal-title":"Rev Esp Anestesiol Reanim"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"196","DOI":"10.1186\/s12871-024-02586-7","article-title":"The analgesic effect of ultrasound-guided cervical erector spinae block in arthroscopic shoulder surgery: a randomized controlled clinical trial","volume":"24","author":"Zhu","year":"2024","journal-title":"BMC Anesthesiol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1702898\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T13:37:17Z","timestamp":1765805837000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1702898\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":34,"alternative-id":["10.3389\/fmed.2025.1702898"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1702898","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2025,12,12]]},"article-number":"1702898"}}