IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0256611.html
   My bibliography  Save this article

Postoperative analgesic effects of paravertebral block versus erector spinae plane block for thoracic and breast surgery: A meta-analysis

Author

Listed:
  • Chang Xiong
  • Chengpeng Han
  • Dong Zhao
  • Wenyong Peng
  • Duojia Xu
  • Zhijian Lan

Abstract

Background: Paravertebral block (PVB) is the most recognized regional anesthesia technique after thoracic epidural anesthesia for postoperative analgesia in thoracic and breast surgery. Erector spinae plane block (ESPB) is a recently discovered blocking technique, and it has evidenced excellent postoperative analgesia for breast and thoracic surgery with fewer adverse reactions. However, there are controversies about the postoperative analgesic effects of the two analgesic techniques. Objective: To assess the analgesic effects of PVB versus ESPB in postoperative thoracic and breast surgery. Methods: We systematically searched PubMed, Cochrane Library, EMBASE, Web of Science, and ScienceDirect databases up to April 5, 2021. The primary outcome was postoperative pain scores. Secondary outcomes included: opioid consumption, additional analgesia, postoperative nausea and vomiting (PONV) 24 hours post-operation, and the time required for completing block procedure. This study was registered in PROSPERO, number CRD42021246160. Results: After screening relevant, full-text articles, ten randomized controlled trials (RCTs) that met the inclusion criteria were retrieved for this meta-analysis. Six studies involved thoracic surgery patients, and four included breast surgery patients. Thoracic surgery studies included all of the outcomes involved in this meta-analysis while breast surgery did not report pain scores at movement and additional analgesia in 24 hours post-operation. For thoracic surgery, PVB resulted in significant reduction in the following pain scores: 0–1 hours (MD = -0.79, 95% CI: -1.54 to -0.03, P = 0.04), 4–6 hours (MD = -0.31, 95% CI: -0.57 to -0.05, P = 0.02), and 24 hours (MD = -0.42, 95% CI: -0.81 to -0.02, P = 0.04) at rest; significant reduction in pain scores at 4–6 hours (MD = -0.47, 95% CI: -0.93 to -0.01, P = 0.04), 8–12 hours (MD = -1.09, 95% CI: -2.13 to -0.04, P = 0.04), and 24 hours (MD = -0.31, 95% CI: -0.57 to -0.06, P = 0.01) at movement. Moreover, the opioid consumption at 24 hours post-operation (MD = -2.74, 95% CI: -5.41 to -0.07, P = 0.04) and the incidence of additional analgesia in 24 hours of the postoperative course (RR: 0.53, 95% CI: 0.29 to 0.97, P = 0.04) were significantly lower in the PVB group than in the ESPB group for thoracic surgery. However, no significant differences were found in pain scores at rest at various time points postoperatively, and opioid consumption at 24 hours post-operation for breast surgery. The time required for completing block procedure was longer in the PVB group than in the ESPB group for thoracic and breast surgery, and the incidence of PONV between the two groups showed no significant difference. Conclusion: The postoperative analgesic effects of PVB versus ESPB are distinguished by the surgical site. For thoracic surgery, the postoperative analgesic effect of PVB is better than that of ESPB. For breast surgery, the postoperative analgesic effects of PVB and ESPB are similar.

Suggested Citation

  • Chang Xiong & Chengpeng Han & Dong Zhao & Wenyong Peng & Duojia Xu & Zhijian Lan, 2021. "Postoperative analgesic effects of paravertebral block versus erector spinae plane block for thoracic and breast surgery: A meta-analysis," PLOS ONE, Public Library of Science, vol. 16(8), pages 1-17, August.
    • Handle: RePEc:plo:pone00:0256611
    DOI: 10.1371/journal.pone.0256611
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0256611
    Download Restriction: no
    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0256611&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pone.0256611?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Paul T E Cusack, 2020. "On Pain," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 31(3), pages 24253-24254, October.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Daniel Niederer & Juliane Mueller, 2020. "Sustainability effects of motor control stabilisation exercises on pain and function in chronic nonspecific low back pain patients: A systematic review with meta-analysis and meta-regression," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-21, January.
    2. Sana Sadiq & Khadija Anasse & Najib Slimani, 2022. "The impact of mobile phones on high school students: connecting the research dots," Technium Social Sciences Journal, Technium Science, vol. 30(1), pages 252-270, April.
    3. Jitka Vseteckova, 2020. "Psychological Therapy for ICT Literate Older Adults in the Time of COVID-19 - Perceptions on the Acceptability of Online Versus Face to Face Versions of a Mindfulness for Later Life Group," Biomedical Journal of Scientific & Technical Research, Biomedical Research Network+, LLC, vol. 31(1), pages 23912-23916, October.
    4. Khalid Ahmed Al-Ansari & Ahmet Faruk Aysan, 2021. "More than ten years of Blockchain creation: How did we use the technology and which direction is the research heading? [Plus de dix ans de création Blockchain : Comment avons-nous utilisé la techno," Working Papers hal-03343048, HAL.
    5. Ling, Gabriel Hoh Teck & Suhud, Nur Amiera binti Md & Leng, Pau Chung & Yeo, Lee Bak & Cheng, Chin Tiong & Ahmad, Mohd Hamdan Haji & Matusin, AK Mohd Rafiq AK, 2021. "Factors Influencing Asia-Pacific Countries’ Success Level in Curbing COVID-19: A Review Using a Social–Ecological System (SES) Framework," SocArXiv b9f2w, Center for Open Science.
    6. Benedict E. DeDominicis, 2021. "Multinational Enterprises And Economic Nationalism: A Strategic Analysis Of Culture," Global Journal of Business Research, The Institute for Business and Finance Research, vol. 15(1), pages 19-66.
    7. Robert J. R. Elliott & Ingmar Schumacher & Cees Withagen, 2020. "Suggestions for a Covid-19 Post-Pandemic Research Agenda in Environmental Economics," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 76(4), pages 1187-1213, August.
    8. Rafał Krupiński, 2020. "Virtual Reality System and Scientific Visualisation for Smart Designing and Evaluating of Lighting," Energies, MDPI, vol. 13(20), pages 1-17, October.
    9. Werner Hölzl & Michael Böheim & Klaus Friesenbichler & Agnes Kügler & Thomas Leoni, 2021. "Staatliche Hilfsmaßnahmen für Unternehmen in der COVID-19-Krise. Eine begleitende Analyse operativer Aspekte und Unternehmenseinschätzungen," WIFO Studies, WIFO, number 66624.
    10. Thorbecke, Willem & Chen, Chen & Salike, Nimesh, 2021. "China’s exports in a protectionist world," Journal of Asian Economics, Elsevier, vol. 77(C).
    11. Óscar Chiva-Bartoll & Honorato Morente-Oria & Francisco Tomás González-Fernández & Pedro Jesús Ruiz-Montero, 2020. "Anxiety and Bodily Pain in Older Women Participants in a Physical Education Program. A Multiple Moderated Mediation Analysis," Sustainability, MDPI, vol. 12(10), pages 1-12, May.
    12. Gigi Foster, 2020. "The behavioural economics of government responses to COVID-19," Journal of Behavioral Economics for Policy, Society for the Advancement of Behavioral Economics (SABE), vol. 4(S3), pages 11-43, December.
    13. Reza Salajegheh & Edward C Nemergut & Terran M Rice & Roy Joseph & Siny Tsang & Bethany M Sarosiek & C Paige Muthusubramanian & Katelyn M Hipwell & Kate B Horton & Bhiken I Naik, 2020. "Impact of a perioperative oral opioid substitution protocol during the nationwide intravenous opioid shortage: A single center, interrupted time series with segmented regression analysis," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-13, June.
    14. Jaroslav Flegr & Radim Kuba & Robin Kopecký, 2020. "Rhesus-minus phenotype as a predictor of sexual desire and behavior, wellbeing, mental health, and fecundity," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-11, July.
    15. Tonata Dengeingei & Laura Uusiku & Olivia N Tuhadeleni & Alice Lifalaza, 2020. "Assessing Knowledge and Practice Regarding the Management of Dysmenorrhea Among Students at University of Namibia Rundu Campus," Global Journal of Health Science, Canadian Center of Science and Education, vol. 12(9), pages 105-105, August.
    16. Craig C Kage & Mohsen Akbari-Shandiz & Mary H Foltz & Rebekah L Lawrence & Taycia L Brandon & Nathaniel E Helwig & Arin M Ellingson, 2020. "Validation of an automated shape-matching algorithm for biplane radiographic spine osteokinematics and radiostereometric analysis error quantification," PLOS ONE, Public Library of Science, vol. 15(2), pages 1-15, February.
    17. Piotr Raźniak & György Csomós & Sławomir Dorocki & Anna Winiarczyk-Raźniak, 2021. "Exploring the Shifting Geographical Pattern of the Global Command-and-Control Function of Cities," Sustainability, MDPI, vol. 13(22), pages 1-15, November.
    18. Felbermayr, Gabriel & Morgan, T. Clifton & Syropoulos, Constantinos & Yotov, Yoto V., 2021. "Understanding economic sanctions: Interdisciplinary perspectives on theory and evidence," European Economic Review, Elsevier, vol. 135(C).
    19. Michael Dolph & Gabriel Tremblay & Hoyee Leong, 2021. "Cost Effectiveness of Triplet Selinexor-Bortezomib-Dexamethasone (XVd) in Previously Treated Multiple Myeloma (MM) Based on Results from the Phase III BOSTON Trial," PharmacoEconomics, Springer, vol. 39(11), pages 1309-1325, November.
    20. Zack Cooper & Joseph J. Doyle Jr. & John A. Graves & Jonathan Gruber, 2022. "Do Higher-Priced Hospitals Deliver Higher-Quality Care?," NBER Working Papers 29809, National Bureau of Economic Research, Inc.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0256611. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.