Evidence map›Paper›PMID 39403896›Full record

SynthesisPaediatric anaesthesia2025

Erector spinae plane block versus intravenous opioid for analgesia in pediatric cardiac surgery: A systematic review and meta-analysis.

Rafael A Lombardi, Eduardo M Pereira, Sara Amaral, Heitor J S Medeiros, Walid Alrayashi

Registry-linked trialAbstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Paediatric anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06848452 (Clinical Study on the Efficacy and Safety of Hydromorphone for ICU Analgesia), which is not on this map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06848452 not yet recruitingnot on this map

Clinical Study on the Efficacy and Safety of Hydromorphone for ICU Analgesia

TypeobservationalSponsorAffiliated Hospital of Nantong UniversityRan2025 to 2027Enrolled300ConditionsAnalgesia, ICU Patients Requiring Invasive Mechanical VentilationArmsno-intervention
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Review
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Rafael A LombardiDepartment of Anesthesiology, University of Nebraska Medical Center, Omaha, Nebraska, USA.ORCID 0000-0001-7104-8237
Eduardo M PereiraDivision of Medicine, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.ORCID 0009-0000-1405-4577
Sara AmaralDepartment of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA.ORCID 0000-0001-5399-668X
Heitor J S MedeirosDepartment of Anesthesiology, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.ORCID 0000-0002-4244-3032
Walid AlrayashiDepartment of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0002-4244-1141

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe erector spinae plane block (ESPB) has recently emerged as a regional anesthesia technique for perioperative pain management in pediatric cardiac surgery. However, evidence comparing its effectiveness with intravenous (IV) opioid-based analgesia is limited. We aimed to evaluate and compare the analgesic efficacy of ESPB versus IV opioids in this setting.

methodsWe systematically reviewed and meta-analyzed studies comparing ESPB with IV opioid analgesia in pediatric cardiac surgeries with midline sternotomy. Primary outcomes were intraoperative fentanyl consumption and intensive care unit (ICU) length of stay (LOS). Secondary outcomes included postoperative opioid consumption, time to first rescue analgesia, pain scores, postoperative vomiting and other complications, extubation time, and hospital LOS. Statistical analyses were performed using RStudio version 4.2.3.

resultsFive studies with 384 patients were included, with 178 receiving ESPB. ESPB significantly reduced intraoperative fentanyl use (MD -1.90 μg.kg

conclusionOur findings suggest the ESPB might be an important adjunct to enhancing analgesia for midline sternotomies in pediatric cardiac surgery, potentially reducing intraoperative opioid requirements and ICU LOS. PROSPERO REGISTRATION: CRD 42024526961.

Indexed as

AnalgesiaAnalgesics, OpioidCardiac Surgical ProceduresNerve BlockPostoperative PainChildHumansPain ManagementParaspinal MusclesAnalgesics, Opioidcardiac surgical procedureserector spinae plane blockintravenous analgesiapediatric surgerypostoperative pain

Identifiers

PMID39403896
PMCPMC11626350

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.