ArticleIndian journal of anaesthesia2025
Efficacy of erector spinae plane block versus caudal block for postoperative analgesia in paediatric surgery: A systematic review and meta-analysis.
Article in Indian journal of anaesthesia, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aims: Regional anaesthesia is a component of multimodal analgesia in paediatric surgery, providing effective pain relief. Traditional techniques, such as the caudal block (CB) and, more recently, fascial plane blocks, such as the erector spinae plane block (ESPB), have gained popularity. This systematic review and meta-analysis compares CB and ESPB in paediatric surgeries involving the lower abdomen or lower limbs. It aims to clarify mixed outcomes from recent trials regarding the variability in analgesic efficacy of both techniques for future practices. Methods: This review, registered with the International Prospective Register of Systematic Reviews (PROSPERO), includes eight randomised controlled trials (RCTs) comparing postoperative analgesia between ESPB and CB in paediatric lower abdominal or lower limb surgeries. We searched the ScienceDirect, Google Scholar, Scopus, ProQuest, and PubMed databases. The meta-analysis assessed the proportion of patients requiring rescue analgesia and postoperative pain intensity. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines were applied to assess the quality of evidence. Result: Eight RCTs (575 patients) were included in the review. A meta-analysis of four RCTs (217 patients) showed no statistically significant difference (inconclusive) between ESPB and CB groups regarding the proportion of patients requiring rescue analgesia [Relative Risk (RR) =0.83, 95% confidence interval (CI): 0.29, 2.40, Conclusion: We conclude that ESPB provides better postoperative analgesia than CB in children undergoing lower abdominal or lower limb surgeries. ESPB reduces postoperative pain intensity scores and analgesic requirements compared to CB.
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