Effects of erector spinae plane block and serratus anterior plane block on postoperative analgesia and recovery in patients with thoracic surgery:a meta analysis
Objective To compare the effects of erector spinae plane block (ESPB) and serratus anteri-or plane block (SAPB) on postoperative analgesia and recovery time in the patients with thoracic surgery by the meta analysis.Methods The databases of Pubmed,Embase,Cochrane Library,Web of Science,CNKI, Wanfang and VIP were systematically retrieved by computer.The studies on the effect of ESPB and SAPB for postoperative analgesia in the patients with thoracic surgery published from January 1,2013 to now were col-lected.The RevMan5.4 software was used to conduct the summary analysis.Results A total of 13 random-ized controlled trials (RCT) involving 929 patients were included,including 464 cases in the ESPB group and 465 cases in the SAPB group.There was no statistically significant difference in the VAS pain scores at rest at postoperative 1,2,6,8,12,24,48 h and during activity at postoperative 2,4,8,12 h between the two groups (P>0.05).The rest VAS score at postoperative 4 h had statistical difference between the ESPB group and SAPB group (MD=-0.15,95%CI:-0.24 to -0.06,P<0.01).The activity VAS scores at postoperative 24 h had statistical difference between the ESPB group and SAPB group(MD=0.74,95%CI:0.01-1.48, P=0.05).There was statistically significant difference in the effective pressing times of analgesic pump at postoperative 48 h between the two groups (MD=-0.19,95%CI:-0.36-0.02,P=0.03).There was no statistically significant difference in the use amount of opioids drugs at postoperative 48 h between the two groups (MD=-5.32,95%CI:-11.76-1.13,P=0.11).There was no statistically significant difference in the incidence rates of postoperative analgesia-related adverse events,nausea and vomiting and skin pruritus between the two groups (MD=1.07,95%CI:0.85-1.34,P=0.58;MD=0.86,95%CI:0.53-1.40,P=0.56).The first time out of bed after surgery (MD=-0.01,95%CI:-0.04-0.05,P=0.81),postoperative eating time (MD=-0.22,95%CI:-0.84-0.40,P=0.49) and postoperative hospitalization stay duration (MD=-0.07,95%CI:-0.64-0.51,P=0.82) had no statistical differences between the two groups.Con-clusion SAPB and ESPB as postoperative analgesic methods all could provide good analgesic effect in the pa-tients with thoracic surgery.ESPB is recommended to use it first for postoperative analgesia in the patients with thoracic surgery