A systematic review and meta-analysis published in Pain Practice indicated that erector spinae plane block (ESPB) can offer an opioid-sparing effect and effective analgesia in people scheduled to undergo surgery with general anesthesia. Moreover, it also boosts development of opioid-free anesthesia.

Researchers aimed to explore the opioid-sparing effects of ESPB in adults during the perioperative period in comparison with conventional analgesia and recognize its role to develop opioid-free anesthesia. Databases like Web of Science, Embase via Ovid, Cochrane Central Register of Controlled Trials, PubMed, and Medline via Ovid were explored to find out the relevant articles.

Randomized controlled trials (RCTs) that evaluated the usage of ESPB with control (no/sham block) were incorporated. Opioid intake at 24 hours after surgery and intraoperative opioid intake was the major endpoint. For calculating odds ratio (OR) and standardized mean difference (SMD), the fixed-effect model was utilized. However, in case of considerable heterogeneity in the data, a random-effects model was utilized.

Overall, 25 RCTs involving 1461 participants were incorporated. The utilization of ESPB was linked with decreased opioid intake at 24 hours following surgery [SMD: -2.14] and during the intraoperative period [SMD: -2.30]. Furthermore, a longer time to provide the first rescue analgesia was noted in ESPB arm [SMD: 3.60]. The group was linked with a reduced occurrence of postoperative nausea or vomiting [OR: 0.50]. Thus, ultrasound-guided ESPB use yields beneficial outcomes during surgery.