Efficacy of erector spinae plane block for analgesia in breast surgery: a systematic review and meta-analysis.
acute pain
breast surgery
erector spinae plane block
paravertebral block
pectoralis nerve block
post-surgical pain
regional anaesthesia
Journal
Anaesthesia
ISSN: 1365-2044
Titre abrégé: Anaesthesia
Pays: England
ID NLM: 0370524
Informations de publication
Date de publication:
03 2021
03 2021
Historique:
accepted:
27
05
2020
pubmed:
2
7
2020
medline:
23
2
2021
entrez:
2
7
2020
Statut:
ppublish
Résumé
The erector spinae plane block is a new regional anaesthesia technique that provides truncal anaesthesia for breast surgery. This systematic review and meta-analysis was undertaken to determine if the erector spinae plane block is effective at reducing pain scores and opioid consumption after breast surgery. This study also evaluated the outcomes of erector spinae plane blocks compared with other regional blocks. PubMed, Embase, Scopus, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov were searched. We included randomised controlled trials reporting the use of the erector spinae plane block in adult breast surgery. Risk of bias was assessed with the revised Cochrane risk-of-bias tool. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework was used to assess trial quality. Thirteen randomised controlled trials (861 patients; 418 erector spinae plane block, 215 no blocks, 228 other blocks) were included. Erector spinae plane block reduced postoperative pain compared with no block: at 0-2 hours (mean difference (95% CI) -1.63 (-2.97 to -0.29), 6 studies, 329 patients, high-quality evidence, I
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
404-413Informations de copyright
© 2020 Association of Anaesthetists.
Références
Poleshuck EL, Katz J, Andrus CH, et al. Risk factors for chronic pain following breast cancer surgery: a prospective study. Journal of Pain 2006; 7: 626-34.
Fecho K, Miller NR, Merritt SA, Klauber-Demore N, Hultman CS, Blau WS. Acute and persistent postoperative pain after breast surgery. Pain Medicine 2009; 10: 708-15.
Gartner R, Jensen MB, Nielsen J, Ewertz M, Kroman N, Kehlet H. Prevalence of and factors associated with persistent pain following breast cancer surgery. Journal of the American Medical Association 2009; 302: 1985-92.
Turan M, Karaman Y, Karaman S, Uyar M, Gonullu M. Postoperative chronic pain after breast surgery with or without cancer: follow up 6 months: 14AP1-7. European Journal of Anaesthesiology 2014; 31: 216.
Wallace MS, Wallace AM, Lee J, Dobke MK. Pain after breast surgery: a survey of 282 women. Pain 1996; 66: 195-205.
Joshi GP, Ogunnaike BO. Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain. Anesthesiology Clinics of North America 2005; 23: 21-36.
Chan JJI, Thong SY, Tan MGE. Factors affecting postoperative pain and delay in discharge from the post-anaesthesia care unit: a descriptive correlational study. Proceedings of Singapore Healthcare 2018; 27: 118-24.
Cali Cassi L, Biffoli F, Francesconi D, Petrella G, Buonomo O. Anesthesia and analgesia in breast surgery: the benefits of peripheral nerve block. European Review for Medical and Pharmacological Sciences 2017; 21: 1341-5.
ELdeen HMS. Ultrasound guided pectoral nerve blockade versus thoracic spinal blockade for conservative breast surgery in cancer breast: a randomized controlled trial. Egyptian Journal of Anaesthesia 2016; 32: 29-35.
Sekandarzad MW, van Zundert AAJ, Lirk PB, Doornebal CW, Hollmann MW. Perioperative anesthesia care and tumor progression. Anesthesia and Analgesia 2017; 124: 1697-708.
Zhao J, Han F, Yang Y, Li H, Li Z. Pectoral nerve block in anesthesia for modified radical mastectomy: A meta-analysis based on randomized controlled trials. Medicine 2019; 98: e15423.
Bakshi SG, Karan N, Parmar V. Pectoralis block for breast surgery: a surgical concern? Indian Journal of Anaesthesia 2017; 61: 851-2.
Naja Z, Lönnqvist PA. Somatic paravertebral nerve blockade. Incidence of failed block and complications. Anaesthesia 2001; 56: 1184-8.
Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The erector spinae plane block: a novel analgesic technique in thoracic neuropathic pain. Regional Anesthesia and Pain Medicine 2016; 41: 621-7.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Medicine 2009; 6: e1000097.
Sterne JAC, Savović J, Page MJ, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. British Medical Journal 2019; 366: 14898.
Langendam MW, Akl EA, Dahm P, Glasziou P, Guyatt G, Schünemann HJ. Assessing and presenting summaries of evidence in Cochrane Reviews. Systematic Reviews 2013; 2: 81.
Faculty of Pain Medicine ANZCA. Opioid calculator - A new horizon in safety, 2016. http://fpm.anzca.edu.au/documents/opioid_calculator_app.pdf (accessed 26/02/2020).
Hozo SP, Djulbegovic B, Hozo I. Estimating the mean and variance from the median, range, and the size of a sample. BMC Medical Research Methodology 2005; 5: 13.
Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan), 2014.
RStudio Team. RStudio: Integrated Developement Environment for R. Boston, MA: RStudio, Inc, 2015.
Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA. Cochrane Handbook for Systematic Reviews of Interventions version 6.0, updated July 2019. www.training.cochrane.org/handbook (accessed March-April/2020).
Aksu C, Kuş A, Yörükoğlu HU, Tor Kiliç C, Gürkan Y. Analgesic effect of the bi-level injection erector spinae plane block after breast surgery: a randomized controlled trial. Agri 2019; 31: 132-7.
Altıparmak B, Korkmaz Toker M, Uysal A, Turan M, Gümüş DS. Comparison of the effects of modified pectoral nerve block and erector spinae plane block on postoperative opioid consumption and pain scores of patients after radical mastectomy surgery: a prospective, randomized, controlled trial. Journal of Clinical Anesthesia 2019; 54: 61-5.
Sharma S, Arora S, Jafra A, Singh G. Efficacy of erector spinae plane block for postoperative analgesia in total mastectomy and axillary clearance: a randomized controlled trial. Saudi Journal of Anaesthesia 2020; 14: 186-91.
El Ghamry MR, Amer AF. Role of erector spinae plane block versus paravertebral block in pain control after modified radical mastectomy. A prospective randomised trial. Indian Journal of. Anaesthesia 2019; 63: 1008-14.
Gad M, Abdelwahab K, Abdallah A, Abdelkhalek M, Abdelaziz M. Ultrasound-guided erector spinae plane block compared to modified pectoral plane block for modified radical mastectomy operations. Anesthesia, Essays and Researches 2019; 13: 334-9.
Moustafa M, Alabd A, Ahmed A, Deghidy E. Erector spinae versus paravertebral plane blocks in modified radical mastectomy: Randomised comparative study of the technique success rate among novice anaesthesiologists. Indian Journal of Anaesthesia 2020; 64: 49-54.
Seelam S, Nair AS, Christopher A, Upputuri O, Naik V, Rayani BK. Efficacy of single-shot ultrasound-guided erector spinae plane block for postoperative analgesia after mastectomy: a randomized controlled study. Saudi Journal of Anaesthesia 2020; 14: 22-7.
Singh S, Kumar G. Akhileshwar. Ultrasound-guided erector spinae plane block for postoperative analgesia in modified radical mastectomy: a randomised control study. Indian Journal of Anaesthesia 2019; 63: 200-4.
Sinha C, Kumar A, Kumar A, Prasad C, Singh P, Priya D. Pectoral nerve versus erector spinae block for breast surgeries: a randomised controlled trial. Indian Journal of Anaesthesia 2019; 63: 617-22.
Swisher MW, Wallace AM, Sztain JF, et al. Erector spinae plane versus paravertebral nerve blocks for postoperative analgesia after breast surgery: a randomized clinical trial. Regional Anesthesia and Pain Medicine 2020; 45: 260-6.
Yao Y, Li H, He Q, Chen T, Wang Y, Zheng X. Efficacy of ultrasound-guided erector spinae plane block on postoperative quality of recovery and analgesia after modified radical mastectomy: randomized controlled trial. Regional Anesthesia and Pain Medicine 2020; 45(1): 5-9.
Gürkan Y, Aksu C, Kuş A, Yörükoğlu UH. Erector spinae plane block and thoracic paravertebral block for breast surgery compared to IV-morphine: a randomized controlled trial. Journal of Clinical Anesthesia 2020; 59: 84-8.
Gürkan Y, Aksu C, Kuş A, Yörükoğlu UH, Kılıç CT. Ultrasound guided erector spinae plane block reduces postoperative opioid consumption following breast surgery: a randomized controlled study. Journal of Clinical Anesthesia 2018; 50: 65-8.
Cepeda MS, Africano JM, Polo R, Alcala R, Carr DB. What decline in pain intensity is meaningful to patients with acute pain? Pain 2003; 105: 151-7.
Schwartzmann A, Peng P, Maciel MA, Forero M. Mechanism of the erector spinae plane block: insights from a magnetic resonance imaging study. Canadian Journal of Anesthesia 2018; 65: 1165-6.
Ivanusic J, Konishi Y, Barrington MJ. A cadaveric study investigating the mechanism of action of erector spinae blockade. Regional Anesthesia and Pain Medicine 2018; 43: 567-71.
Altıparmak B, Korkmaz Toker M, Uysal A, Gümüş DS. Comparison of the efficacy of erector spinae plane block performed with different concentrations of bupivacaine on postoperative analgesia after mastectomy surgery: ramdomized, prospective, double blinded trial. BMC Anesthesiology 2019; 19: 31.
Wisotzky EM, Saini V, Kao C. Ultrasound-guided intercostobrachial nerve block for intercostobrachial neuralgia in breast cancer patients: a case series. PM & R : The Journal of Injury, Function and Rehabilitation 2016; 8: 273-7.
Woodworth GE, Ivie RMJ, Nelson SM, Walker CM, Maniker RB. Perioperative breast analgesia: a qualitative review of anatomy and regional techniques. Regional Anesthesia and Pain Medicine 2017; 42: 609-31.
Veiga M, Costa D, Brazão I. Erector spinae plane block for radical mastectomy: a new indication? Revista Espanola de Anestesiologia y Reanimacion 2018; 65: 112-5.
Malawat A, Verma K, Jethava D, Jethava DD. Erector spinae plane block for complete surgical anaesthesia and postoperative analgesia for breast surgeries: a prospective feasibility study of 30 cases. Indian Journal of Anaesthesia 2020; 64: 118-24.
Byrne K, Smith C. Human volunteer study examining the sensory changes of the thorax after an erector spinae plane block. Regional Anesthesia and Pain Medicine 2020; rapm-2019-101019. https://doi.org/10.1136/rapm-2019-101019.
Lönnqvist PA, MacKenzie J, Soni AK, Conacher ID. Paravertebral blockade. Failure rate and complications. Anaesthesia 1995; 50: 813-5.
Moore RA, Mhuircheartaigh RJN, Derry S, McQuay HJ. Mean analgesic consumption is inappropriate for testing analgesic efficacy in post-operative pain: analysis and alternative suggestion. European Journal of Anaesthesiology 2011; 28: 427-32.
Committee for Proprietary Medicinal Products. Note for guidance on clinical investigation of medicinal products for treatment of nociceptive pain, 2002. https://www.ema.europa.eu/en/documents/scientific-guideline/note-guidance-clinical-investigation-medicinal-products-treatment-nociceptive-pain_en.pdf (accessed 12/05/2020).
Myles PS, Christelis N. Measuring pain and analgesic response. European Journal of Anaesthesiology 2011; 28: 399-400.