Comparison of analgesic effects between erector spinae plane block and serratus anterior plane block in breast and thoracic surgery: a systemic review and meta-analysis

Background: Although erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) provide effective analgesia following breast and thoracic surgical procedures, the relative analgesic efficiency of these blocks remains unclear.This meta-analysis aimed to compare the analgesic outcomes of ESPB and SAPB in patients undergone breast and thoracic surgery. Methods: Systematic searches were conducted on Embase, Cochrane Library, Web of Science and PubMed from their inception until 31 December 2023, to quantify intraoperative and postoperative opioid consumption with mean differences (MDs) and 95% confidence intervals (CIs) using random-effects models. The degree of certainty for evidence was assessed using the Grade of Recommendations, Assessment, Development and Evaluation (GRADE) framework. Results: In total, nine articles were included in the current study. The meta-analysis revealed that ESPB significantly reduced intraoperative opioid use (MD = −2.32 mg, 95% CI (−3.92, −0.73); p < 0.01, I2 = 65%) and postoperative opioid consumption (MD = −4.86 mg, 95% CI (−7.85, −1.88); p < 0.01, I2 = 95%) compared to SAPB. Furthermore, the need for rescue analgesia was lower in the ESPB group, and the differences in the incidence of nausea and vomiting were not significant between the two groups. Conclusions: ESPB might offer superior analgesic effects compared to SAPB in patients after thoracic and breast surgery. However, further studies are necessary to confirm this conclusion due to the low quality of evidence. Registration number: This meta-analysis has been registered to PROSPERO: CRD42022322760.

Serratus anterior plane block; Opioid consumption; Erector spinae plane block; Meta-analysis

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