Evidence map›Paper›PMID 42204465›Full record

SynthesisBMC anesthesiology2026

Effect of erector spinae block on postoperative outcomes in patients undergoing lung surgical procedures: a systematic review and trial sequential analysis of randomized controlled trials.

Vitaliy Voznyy, Mouad Elganga, Leya Tawfik, Salem Abu Al-Burak, Yamini Subramani, Paymon Azizi, Lee-Anne Fochesato, Pavel S Roshanov, Rahul Nayak, Richard Malthaner and 1 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC anesthesiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

11 authors.

Vitaliy Voznyy *Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Mouad Elganga *Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Leya TawfikTemerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Salem Abu Al-BurakSchulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
Yamini SubramaniDepartment of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, Room C3-127, London, Ontario, N6A 5A5, Canada.
Paymon AziziDepartment of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, Room C3-127, London, Ontario, N6A 5A5, Canada.
Lee-Anne FochesatoDepartment of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, Room C3-127, London, Ontario, N6A 5A5, Canada.
Pavel S RoshanovDepartment of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, N6A 5A5, Canada.
Rahul NayakDivision of Thoracic Surgery, Department of Surgery, London Health Sciences Centre and St Joseph Health Care, Schulich School of Medicine and Dentistry, Lawson Health Research Institute, Western University, London, ON, Canada.
Richard MalthanerDivision of Thoracic Surgery, Department of Surgery, London Health Sciences Centre and St Joseph Health Care, Schulich School of Medicine and Dentistry, Lawson Health Research Institute, Western University, London, ON, Canada.
Mahesh NagappaDepartment of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, Room C3-127, London, Ontario, N6A 5A5, Canada. Mahesh.Nagappa@lhsc.on.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLung surgery is often accompanied by significant pain, leading to high opioid use and related side effects. This systematic review and meta-analysis examine the effect of the erector spinae plane block (ESPB) in reducing postoperative pain, opioid consumption, and postoperative nausea and vomiting (PONV) after lung surgery.

methodsA systematic database search was conducted to identify randomized controlled trials (RCTs) comparing ESPB with a control in patients undergoing lung surgical procedures. The primary outcome was the early (6 h), intermediate (12 h), and late (24 h) pain scores at rest and during movement. The secondary outcomes were 24 h postoperative opioid consumption and postoperative nausea and vomiting. Mean differences (MD) and odds ratios (OR) with 95% confidence intervals (CI) were calculated using a random-effects model.

results20 RCTs with 1,391 patients were included in the meta-analysis (ESPB vs. control: 668 vs. 723). ESPB significantly reduced resting pain at 6 h (MD: 1.26; 95% CI: 0.78-1.75; p < 0.00001), 12 h (MD: 1.22; 95% CI: 0.41-2.03; p = 0.003), and 24 h (MD: 0.61; 95% CI: 0.33-0.90; p < 0.0001). Similarly, movement-evoked pain was reduced at 6 h (MD: 1.54; 95% CI: 0.71-2.37; p < 0.0001), 12 h (MD: 1.32; 95% CI: 0.88-1.76; p < 0.00001), and 24 h (MD: 0.91; 95% CI: 0.36-1.46; p = 0.001). Ten RCTs showed reduced 24-hour postoperative opioid consumption (MD: 16.74; 95% CI: 7.28-26.19; p = 0.0005) and decreased PONV incidence (OR: 0.32; 95% CI: 0.20-0.51; p < 0.001) in the ESPB group. Although statistically significant, the observed reductions in pain scores correspond to modest absolute differences of approximately 1-1.5 points on a 10-point scale in the early postoperative period and less than 1 point at 24 h. The certainty of evidence across all outcomes was low, primarily due to substantial clinical heterogeneity and variability in study protocols.

conclusionESPB appears to provide modest but consistent improvements in postoperative pain control, opioid consumption, and PONV after lung surgery. However, given the low certainty of evidence (GRADE) and substantial between-study heterogeneity, these findings support ESPB as an adjunct rather than a definitive regional analgesic strategy for lung surgery.

Indexed as

LungNerve BlockPostoperative PainAnalgesics, OpioidHumansParaspinal MusclesPostoperative Nausea and VomitingRandomized Controlled Trials as TopicTreatment OutcomeAnalgesics, OpioidAcute PainErector Spinae BlockNerve BlockOpioid consumptionThoracic Surgical ProceduresVideo-Assisted Thoracic Surgery

Identifiers

PMID42204465
PMCPMC13397780

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.