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Purpose <p>Inguinal hernia repair is one of the most common procedures performed by general surgeons worldwide, but postoperative and chronic pain remain significant challenges. This systematic review and meta-analysis aimed to evaluate the efficacy of the erector spinae plane (ESP) block in managing postoperative pain after unilateral inguinal hernia repair.</p> Methods <p>We searched PubMed, Embase, and the Web of Science for studies published up to November 2024. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was assessed using I² statistics. Statistical analysis was performed with R Software version 4.4.1 (R Foundation for Statistical Computing).</p> Results <p>Four randomized controlled trials were included, encompassing 181 patients who underwent inguinal hernia repair. Of these, 91 (50.3%) were allocated to receive anesthesia with an erector spinae plane (ESP) block, while 90 (49.7%) were assigned to the control group. Compared to conventional anesthesia, the ESP block group demonstrated significantly lower pain scores at 6&#xa0;h (MD -1.5; 95% CI [-2.5, -0.4]; <i>p</i> &lt; 0.01; I²=85%) and 12&#xa0;h (MD -0.8; 95% CI [-1.4, -0.2]; <i>p</i> &lt; 0.01; I²=48%). Additionally, ESP block was associated with reduced rates of nausea and vomiting (RR 0.36; 95% CI [0.15, 0.88]; <i>p</i> = 0.025; I²=0%). No significant differences were observed between the groups in pain scores at 2 and 24&#xa0;h or in analgesic requirements.</p> Conclusion <p>Inguinal hernia repair with an ESP block lowered postoperative pain scores and reduced postoperative nausea and vomiting.</p>

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Erector spinae plane block following inguinal hernia repair in adults: a systematic review and meta-analysis of randomized controlled trials

  • 期刊论文

  • 发表日期：

    2025年4月12日

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  • Bernardo Fontel Pompeu,
  • Patricia Marcolin,
  • Mariana Pereira Silva,
  • Lucas Monteiro Delgado,
  • Beatriz D’Andrea Pigossi,
  • Williams Barbosa Melo,
  • Sergio Mazzola Poli de Figueiredo

摘要

Purpose

Inguinal hernia repair is one of the most common procedures performed by general surgeons worldwide, but postoperative and chronic pain remain significant challenges. This systematic review and meta-analysis aimed to evaluate the efficacy of the erector spinae plane (ESP) block in managing postoperative pain after unilateral inguinal hernia repair.

Methods

We searched PubMed, Embase, and the Web of Science for studies published up to November 2024. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was assessed using I² statistics. Statistical analysis was performed with R Software version 4.4.1 (R Foundation for Statistical Computing).

Results

Four randomized controlled trials were included, encompassing 181 patients who underwent inguinal hernia repair. Of these, 91 (50.3%) were allocated to receive anesthesia with an erector spinae plane (ESP) block, while 90 (49.7%) were assigned to the control group. Compared to conventional anesthesia, the ESP block group demonstrated significantly lower pain scores at 6 h (MD -1.5; 95% CI [-2.5, -0.4]; p < 0.01; I²=85%) and 12 h (MD -0.8; 95% CI [-1.4, -0.2]; p < 0.01; I²=48%). Additionally, ESP block was associated with reduced rates of nausea and vomiting (RR 0.36; 95% CI [0.15, 0.88]; p = 0.025; I²=0%). No significant differences were observed between the groups in pain scores at 2 and 24 h or in analgesic requirements.

Conclusion

Inguinal hernia repair with an ESP block lowered postoperative pain scores and reduced postoperative nausea and vomiting.