Erector spinae plane block for laparoscopic surgeries: a systematic review and meta-analysis

Oraee, Soroush; Rajai Firouzabadi, Shahryar; Mohammadi, Ida; Alinejadfard, Mohammadreza; Golsorkh, Hossein; Hatami, Sara

doi:10.1186/s12871-024-02775-4

BMC Anesthesiology

Table 2 GRADE assessments

From: Erector spinae plane block for laparoscopic surgeries: a systematic review and meta-analysis

Certainty assessment							№ of patients		Effect	Certainty
№ of studies	Study design	Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations	ESPB	comparison	Effect	Certainty
ESPB vs Placebo
24 h Post Operation Opioid Consumption
22	randomized trials	not serious	not serious	not serious	not serious	publication bias strongly suspected^a	644	648	SMD-1.837	⨁⨁⨁◯ Moderate^a
Participant Reported Pain Scores at Rest
21	randomized trials	not serious	serious^b	not serious	not serious	publication bias strongly suspected^a	742	750	SMD-0.612	⨁⨁◯◯ Low^a,b
Time to First Rescue Analgesic Request
9	randomized trials	not serious	very serious^c	not serious	not serious	publication bias strongly suspected^a	313	321	SMD + 3.945	⨁◯◯◯ Very low^a,c
Post-Operative Nausea or Vomiting
14	randomized trials	not serious	not serious	not serious	not serious	none	403	407	RR + 0.491	⨁⨁⨁⨁ High
ESPB vs TAPB
24 h Post Operation Opioid Consumption
11	randomized trials	not serious	not serious	not serious	not serious	publication bias strongly suspected^d	416	413	SMD-1.351	⨁⨁⨁◯ Moderate^d
Participant Reported Pain Scores at Rest
9	randomized trials	not serious	not serious	not serious	not serious	none	359	362	SMD-0.465	⨁⨁⨁⨁ High
Time to First Rescue Analgesic Request
7	randomized trials	not serious	not serious	not serious	not serious	publication bias strongly suspected^a	243	243	SMD + 1.456	⨁⨁⨁◯ Moderate^a
Post-Operative Nausea or Vomiting
5	randomized trials	not serious	not serious	not serious	not serious	none	209	212	RR + 0.511	⨁⨁⨁⨁ High
ESPB vs QLB
24 h Post Operation Opioid Consumption
5	randomized trials	not serious	not serious	not serious	serious^d	none	163	168	SMD + 0.022	⨁⨁⨁◯ Moderate^d
Participant Reported Pain Scores at Rest
4	randomized trials	not serious	not serious	not serious	serious^d	none	146	150	SMD + 1.025	⨁⨁⨁◯ Moderate^d
Time to First Rescue Analgesic Request
2	randomized trials	not serious	not serious	not serious	serious^d	publication bias strongly suspected^a	52	54	SMD + 0.285	⨁⨁◯◯ Low^a,d
Post-Operative Nausea or Vomiting
3	randomized trials	not serious	not serious	not serious	serious^d	publication bias strongly suspected^a	114	117	RR + 0.778	⨁⨁◯◯ Low^a,d

CI confidence interval, ESPB Erector Spinae Plane Block, TAPB transversus abdominis plane block, QLB quadratus lumborum block, RR risk ratio, SMD standardized mean difference
Explanations
a. Due to potential publication bias, we decided to downgrade once for strong susceptibility to publication bias
b. Due to a heterogeneity greater than 50%, we decided to downgrade once for serious inconsistency
c. Due to a heterogeneity greater than 75%, we decided to downgrade twice for very serious inconsistency
d. Due to the small sample size or small number of articles, we decided to downgrade once for serious imprecision

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