{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:33:24Z","timestamp":1786649604049,"version":"build-2736575974"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Paravertebral block (PVB) and erector spinae plane block (ESPB) are commonly used truncal blocks for thoracic and upper abdominal surgeries in adults and children. ESPB is a superficial block, easy to perform, and relatively safe with fewer complications compared to PVB, which is a deeper block, requiring more technical expertise. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) to generate evidence on the analgesic efficacy of ESPB compared with PVB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO). We systematically searched PubMed, Scopus, and Google Scholar for RCTs comparing ESPB with PVB in children from inception to date. Time to first rescue analgesic dose was taken as the primary outcome. Analgesic consumption in the first 24 h in the postoperative period, pain scores at different time intervals, and postoperative complications were recorded as secondary outcomes. Random-effects meta-analyses were performed in R (REML estimator), reporting pooled effect, 95% confidence interval (CI), \u03c4\u00b2, I\u00b2, and the Q test for heterogeneity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Four trials (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 252) were pooled for the time to first rescue analgesia. ESP block was associated with a shorter time to rescue versus PVB: mean difference (MD) = \u22120.50 h (95% CI: \u22120.84, \u22120.17) with negligible heterogeneity (\u03c4\u00b2 = 0; I\u00b2 =0%; Q (3) = 0.93,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.818). No significant differences were seen in the pain scores at 0 h SMD = \u22120.10 (95% CI: 0.41, 0.22); I\u00b2 = 9.9% (Q (2) = 2.07,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.354) and 12 h SMD = 0.20 (95% CI: \u22120.20, 0.61); I\u00b2 = 43.2% (Q (2) = 3.47,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.176). One study reported hematoma in 10% cases, and another study reported pneumothorax in 3% cases in the PVB group. No complications were seen in ESPB group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The evidence suggests PVB prolongs postoperative analgesia compared to ESPB in children, but with an increased rate of complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_1112_25","type":"journal-article","created":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T10:00:33Z","timestamp":1767348033000},"page":"15-26","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Analgesic efficacy of erector spinae plane block compared with paravertebral block in children: A systematic review and meta-analysis of randomised controlled trials"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4360-726X","authenticated-orcid":false,"given":"M. S","family":"Sarathkumar","sequence":"first","affiliation":[{"name":"Senior Resident, Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3085-1802","authenticated-orcid":false,"given":"Divya","family":"Jain","sequence":"additional","affiliation":[{"name":"Professor, Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5670-7932","authenticated-orcid":false,"given":"Venkata","family":"Ganesh","sequence":"additional","affiliation":[{"name":"Assistant Professor, Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1691-4953","authenticated-orcid":false,"given":"Ashok","family":"Kumar","sequence":"additional","affiliation":[{"name":"Tutor, National Institute of Nursing Education, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3006-8723","authenticated-orcid":false,"given":"G","family":"Karnika","sequence":"additional","affiliation":[{"name":"Resident, Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3792-0401","authenticated-orcid":false,"given":"Preethy J","family":"Mathew","sequence":"additional","affiliation":[{"name":"Professor, Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1,2]]},"reference":[{"key":"R1-20260102","doi-asserted-by":"crossref","first-page":"1353","DOI":"10.1213\/ANE.0b013e31825d9f4b","article-title":"Pediatric Regional Anesthesia Network (PRAN): A multi-institutional study of the use and incidence of complications of pediatric regional anesthesia","volume":"115","author":"Polaner","year":"2012","journal-title":"Anesth Analg"},{"key":"R2-20260102","doi-asserted-by":"crossref","first-page":"24","DOI":"10.4103\/aca.ACA_83_19","article-title":"Efficacy of paravertebral block in \u201cFast-tracking\u201d pediatric cardiac surgery - Experiences from a tertiary care center","volume":"24","author":"Sahajanandan","year":"2021","journal-title":"Ann Card Anaesth"},{"key":"R3-20260102","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1093\/bja\/aew387","article-title":"Paravertebral block in paediatric abdominal surgery\u2014A systematic review and meta-analysis of randomized trials","volume":"118","author":"Page","year":"2017","journal-title":"Br J Anaesth"},{"key":"R4-20260102","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1053\/j.jvca.2022.12.006","article-title":"Effects of thoracic paravertebral block on postoperative analgesia in infants and small children undergoing ultra-fast track cardiac anesthesia: A randomized controlled trial","volume":"37","author":"Feng","year":"2023","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"R5-20260102","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.redar.2021.05.024","article-title":"Continuous thoracic paravertebral analgesia after minimally invasive atrial septal defect closure surgery in pediatric population: Effectiveness and safety analysis","volume":"69","author":"\u00c1lvarez-Baena","year":"2022","journal-title":"Rev Esp Anestesiol Reanim (Engl 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Med"},{"key":"R9-20260102","doi-asserted-by":"crossref","first-page":"111575","DOI":"10.1016\/j.jclinane.2024.111575","article-title":"Analgesic efficacy and safety of erector spinae plane block in pediatric patients undergoing elective surgery: A systematic review and Meta-analysis of randomised controlled trials","volume":"98","author":"Park","year":"2024","journal-title":"J Clin Anesth"},{"key":"R10-20260102","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomized trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"R11-20260102","doi-asserted-by":"crossref","first-page":"22","DOI":"10.58675\/2682-339X.2753","article-title":"A comparative study between ultrasound guided erector spinae plane block versus paravertebral block for perioperative pain control in pediatric laparoscopic surgeries","volume":"5","author":"Ismael","year":"2024","journal-title":"Al-Azhar Int Med J"},{"key":"R12-20260102","doi-asserted-by":"crossref","first-page":"193","DOI":"10.25237\/revchilanestv5226121150","article-title":"Comparison of ultrasound-guided thoracic erector spinae plane block versus paravertebral block for analgesia after pediatric cardiac surgery","volume":"52","author":"Elsharkawy","year":"2023","journal-title":"Rev Chil Anest"},{"key":"R13-20260102","first-page":"686","article-title":"Comparison of single-dose erector spinae plane block versus paravertebral block for pyeloplasty surgery in children \u2013 A prospective, randomized study","volume":"40","author":"Kundal","year":"2024","journal-title":"J Anaesthesiol Clin Pharmacol"},{"key":"R14-20260102","doi-asserted-by":"crossref","first-page":"425","DOI":"10.36076\/ppj.2024.27.425","article-title":"Erector spinae plane block provided comparable analgesia as thoracic paravertebral block post pediatric nuss procedure for pectus excavatum: A randomized controlled trial","volume":"27","author":"Xu","year":"2024","journal-title":"Pain Physician"},{"key":"R15-20260102","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1111\/j.1460-9592.2008.02592.x","article-title":"Single-injection paravertebral block for renal surgery in children","volume":"18","author":"Berta","year":"2008","journal-title":"Paediatr Anaesth"},{"key":"R16-20260102","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1177\/0310057X1103900517","article-title":"Single level paravertebral versus caudal block in paediatric inguinal surgery","volume":"39","author":"Tug","year":"2011","journal-title":"Anaesth Intensive Care"},{"key":"R17-20260102","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1213\/ANE.0000000000001576","article-title":"Thoracic paravertebral nerve blocks in pediatric patients: Safety and clinical experience","volume":"123","author":"Vecchione","year":"2016","journal-title":"Anesth 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History"}},{"value":"2025-11-03","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}