Erector spinae plane block versus transversus abdominis plane block for analgesia after cesarean section: a systematic review and meta-analysis

被引:1
作者
Mansour, Mariana AbdElSayed [1 ]
Baradwan, Saeed [2 ]
Shama, Ahmed Abdelaziz [3 ]
Mahmoud, Mohamed Ali [4 ]
Abouelnour, Ayman Salah [5 ]
Mohamed, Ayman Mohamed AbdelWahed [6 ]
Elkhouly, Ahmed Fathi Hassan [5 ]
Elsayed, Abdelkarem Hussiny Ismail [5 ]
Rashed, Zaky Ftouh [7 ]
Abdelhakim, Ahmed Mohamed [8 ]
Almutairi, Mrooj Mabruk [9 ]
Lotfy, Mohamed A. [3 ]
Ahmed, Ahmed Goda [1 ]
机构
[1] Beni Suef Univ, Fac Med, Dept Anesthesiol Surg Intens Care & Pain Managemen, Bani Suwayf, Egypt
[2] King Faisal Specialist Hosp & Res Ctr, Dept Obstet & Gynecol, Jeddah, Saudi Arabia
[3] Tanta Univ, Fac Med, Dept Anesthesiol Surg Intens Care & Pain Managemen, Tanta, Egypt
[4] Al Azhar Univ, Fac Med, Dept Anesthesia & Intens Care & Pain Management, Assiut, Egypt
[5] Al Azhar Univ, Fac Med, Dept Anesthesia & Intens Care & Pain Management, Cairo, Egypt
[6] Al Azhar Univ, Int Islamic Ctr Populat Studies & Res, Dept Anesthesiol Surg Intens Care & Pain Managemen, Cairo, Egypt
[7] Al Maarefa Univ, Coll Appl Sci, Dept Anesthesia, Riyadh, Saudi Arabia
[8] Cairo Univ, Fac Med, Kasralainy, Cairo, Egypt
[9] King Abdulaziz Univ, Fac Med, Jeddah, Saudi Arabia
来源
BRAZILIAN JOURNAL OF ANESTHESIOLOGY | 2025年 / 75卷 / 04期
关键词
Anesthesia; Cesarean section; Meta-analysis; Obstetrics; Systematic review; QUADRATUS LUMBORUM BLOCK; POSTOPERATIVE ANALGESIA; DELIVERY; BIAS; PAIN;
D O I
10.1016/j.bjane.2025.844606
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: Peripheral abdominal nerve blocks are key components of multimodal analgesia, enhancing recovery after cesarean sections. This systematic review and meta-analysis aimed to assess analgesic efficacy of Erector Spinae Plane Block (ESPB) versus Transversus Abdominis Plane Block (TAPB) under ultrasound guidance following Cesarean Section (CS) under spinal anesthesia. Methods: A comprehensive search was conducted across PubMed, Scopus, Cochrane Library, and ISI Web of Science to identify relevant trials. The inclusion criteria followed the PICOS framework: Population (women undergoing elective cesarean delivery), Intervention (ESPB), Comparator (TAPB), Outcomes (postoperative pain, opioid consumption, analgesic duration, and satisfaction), and Study Design (randomized controlled trials). Results: Seven RCTs (380-patients) met the inclusion criteria. The ESPB group had significantly lower postoperative pain scores at rest and during movement, reduced 24-hour opioid consumption (MD =-2.62 MME; 95% CI-4.11 to-1.13; p = 0.006), and longer analgesic duration (SMD = 1.77; 95% CI 1.11 to 2.44; p <0.001) than the TAPB group. Patient satisfaction was also significantly higher in the ESPB group (OR = 4.75; 95% CI 2.26 to 9.99; p < 0.001). While most outcomes demonstrated low heterogeneity, significant variability was observed in analgesic duration (I2 = 83%), requiring cautious interpretation. Conclusions: The ESP block offers superior pain relief, reduces opioid use, and enhances satisfaction compared to the TAP block in cesarean sections. These findings suggest that the implementation of the ESP block in postoperative analgesia protocols could significantly improve patient outcomes, potentially leading to enhanced recovery and reduced reliance on opioids. (c) 2025 Sociedade Brasileira de Anestesiologia. Published by Elsevier Espa & ntilde;a, S.L.U. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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页数:12
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