Dados do Trabalho

Título

Erector spinae plane block in cardiac surgery: a systematic review with meta-analysis

Objetivo

The objective of our systematic review was to evaluate the effectiveness of Erector Spinae Plane Block (ESPB) in cardiac surgery for postoperative pain management, assessing opioid consumption and pain reduction.

Métodos

A systematic review and meta-analysis following PRISMA guidelines were conducted using databases like PubMed, SCOPUS, Cochrane, EMBASE, and Web of Science. Inclusion criteria selected studies addressing ESPB in cardiac surgeries, while reviews, letters, and editorials were excluded. A total of 8 clinical studies were included. Two independent reviewers evaluated the studies, with disagreements resolved through consensus or by a third reviewer. Data analysis was performed using Review Manager (RevMan), employing fixed or random effects models based on heterogeneity, measured by the I² index.

Resultados

ESPB significantly reduced pain at the 4th, 6th, and 12th hours post-extubation with combined differences of -1.51, -0.67, and -0.49, respectively. Intraoperative fentanyl consumption decreased significantly by -167.37, and extubation time was shorter by - 39.46 minutes in the ESPB group. However, study heterogeneity varied, with I² at 13% for pain and 100% for fentanyl consumption.

Conclusão

The review highlights the benefits of ESPB in managing postoperative pain in cardiac surgeries, showing significant pain reduction, lower fentanyl use, and shorter extubation times. However, due to study heterogeneity, consistent formal recommendations cannot be made, emphasizing the need for more standardized clinical trials.