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Background <p>The Erector Spinae Plane Block (ESPB) is a well-known regional anesthesia technique in adults. However, its effectiveness and analgesic efficiency have yet to be fully established in children. This meta-analysis aimed to determine the analgesic efficacy of ESPB in pediatric surgery.</p> Methods <p>Following PRISMA guidelines, we conducted a meta-analysis of prospective randomized clinical trials that compared the effects of ESPB versus the control group or different peripheral nerve blocks in pediatric surgery.</p> Results <p>Ten randomized controlled trials, involving 651 pediatric patients, were included in the synthesis following critical appraisal. Compared to no-block analgesia, ESPB significantly prolonged the time to the first rescue analgesia (SMD 1.30, 95% CI 0.38 to 2.22; <i>p =</i> 0.005) and reduced postoperative opioid consumption at 24&#xa0;h (SMD -1.08, 95% CI -2.03 to -0.13; <i>p =</i> 0.03). ESPB also significantly lowered pain scores at 4&#xa0;h (<i>p =</i> 0.008) and 6&#xa0;h (<i>p =</i> 0.0003) postoperatively compared to no-block analgesia. However, ESPB did not significantly reduce intraoperative fentanyl consumption (SMD -0.21, 95% CI -1.14 to 0.71; <i>p =</i> 0.65).</p> Conclusion <p>ESPB improved analgesic efficacy in pediatric surgery, particularly compared with caudal or no-block analgesia; however, the overall certainty of evidence ranged from low to moderate according to the GRADE approach. Further high-quality, methodologically robust RCTs are required.</p> Trial registration <p>The study was registered in the International Register of Systematic Reviews (PROSPERO) and is available online (<a href="http://www.crd.york.uk/prospero">www.crd.york.uk/prospero</a>, CRD42023483105).</p>

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Erector spinae plane block in pediatric surgery: a systematic review and meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月17日

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  • Małgorzata Reysner,
  • Tomasz Reysner,
  • Grzegorz Kowalski,
  • Piotr Janusz,
  • Aleksander Mularski,
  • Przemysław Daroszewski,
  • Jerzy Kolasiński,
  • Katarzyna Wieczorowska-Tobis

摘要

Background

The Erector Spinae Plane Block (ESPB) is a well-known regional anesthesia technique in adults. However, its effectiveness and analgesic efficiency have yet to be fully established in children. This meta-analysis aimed to determine the analgesic efficacy of ESPB in pediatric surgery.

Methods

Following PRISMA guidelines, we conducted a meta-analysis of prospective randomized clinical trials that compared the effects of ESPB versus the control group or different peripheral nerve blocks in pediatric surgery.

Results

Ten randomized controlled trials, involving 651 pediatric patients, were included in the synthesis following critical appraisal. Compared to no-block analgesia, ESPB significantly prolonged the time to the first rescue analgesia (SMD 1.30, 95% CI 0.38 to 2.22; p = 0.005) and reduced postoperative opioid consumption at 24 h (SMD -1.08, 95% CI -2.03 to -0.13; p = 0.03). ESPB also significantly lowered pain scores at 4 h (p = 0.008) and 6 h (p = 0.0003) postoperatively compared to no-block analgesia. However, ESPB did not significantly reduce intraoperative fentanyl consumption (SMD -0.21, 95% CI -1.14 to 0.71; p = 0.65).

Conclusion

ESPB improved analgesic efficacy in pediatric surgery, particularly compared with caudal or no-block analgesia; however, the overall certainty of evidence ranged from low to moderate according to the GRADE approach. Further high-quality, methodologically robust RCTs are required.

Trial registration

The study was registered in the International Register of Systematic Reviews (PROSPERO) and is available online (www.crd.york.uk/prospero, CRD42023483105).