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EP015 Pain management in thoracic surgeries: a systematic review and meta-analysis comparing erector spinae and serratus anterior plane blocks
  1. Sara Amaral1,
  2. Heitor Medeiros2,
  3. Carolina Sousa Dias3 and
  4. Rafael Lombardi4
  1. 1Anesthesiology, Hospital Regional Deputado Afonso Guizzo, Ararangua, Brazil
  2. 2Anesthesiology, Hospital Universitário Onofre Lopes, Natal, Brazil
  3. 3Anesthesiology, Centro Hospitalar e Universitário Lisboa Central, Lisbon, Portugal
  4. 4Anesthesiology, University of Nebraska Medical Center, Omaha, USA


Background and Aims The Erector Spinae Plane Block (ESPB) and the Serratus Anterior Plane Block (SAPB) are potential options for surgeries in the thorax. This study aims to compare the efficacy and safety between them.

Methods PubMed, EMBASE, and Cochrane were searched for RCTs comparing the ESPB to the SAPB. The outcomes included opioid consumption intraoperatively and in the first 24 h, pain scores, postoperative nausea and vomiting (PONV), and block-related complications incidences. RevMan 5.4 analyzed data and sensitivity analysis was conducted by systematically removing each study. (PROSPERO – CRD42023415421)

Results The study analyzed six RCTs with 405 patients, 50% underwent ESPB. Intraoperative opioid consumption was significantly lower in the ESPB group (figure 1). No significant differences were found in pain scores at rest or movement at 2h (MD4 -0.28; 95% CI -1.01 to 0.44; p=0.44 and MD -0.14; 95% CI -0.54 to 0.27; p=0.51) and 12h (MD -0.15; 95% CI -0.53 to 0.22; p=0.43 and MD -0.55; 95% CI -1.24 to 0.14; p=0.12). However, at 24h, there were significantly lower pain scores for the ESPB group when in movement (figure 3) and overall block-related complications, there were no significant differences. Sensitivity analysis did not change the overall conclusion in any of the outcomes evaluated.

Abstract EP015 Figure 1

Intraoperative opioid consumption was significantly lower in the ESPB group

Abstract EP015 Figure 2

At 24h there were significant lower pain scores for the ESPB group when in movement (Figure 2A) and a similar tendency for when in rest (Figure 2B)

Abstract EP015 Figure 3

There were no significant differences regarding PONV incidence between the groups

Conclusions Our findings suggest that ESPB may be more effective than SAPB for thoracic surgeries, although the safety profile is similar.

  • serratus anterior plane block
  • serratus anterior
  • erector spinae plane block
  • ESP block
  • ESP
  • thoracic surgery
  • meta-analysis

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