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All Journal Solo Journal of Anesthesi, Pain and Critical Care
Rizky Rahmad Tri Cahyo
Resident anesthesiology and intensive care, Diponegoro University
Chemical Engineering, Chemistry & Bioengineering Health Professions Medicine & Pharmacology Nursing Public Health

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Erector Spinae Block vs Paravertebral Block in Breast Cancer Surgery: A Systematic Review and Meta-analysis Rizky Rahmad Tri Cahyo; Doso Sutiyono; Intan Karmila; Ismini Aufakamilia
Solo Journal of Anesthesi, Pain and Critical Care (SOJA) Vol 5, No 2 (2025): October 2025
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/soja.v5i2.67351

Abstract

 Background :The paravertebral block (PVB) is the gold standard for postoperative analgesia in breast surgery, but it easily causes pneumothorax. Erector spinae plane block (ESPB) is considered as alternative to PVB because its less invasive so relative safer. However, evidence in favor of these techniques is lacking. Method :A search of PubMed Central, Cochrane Library, Wiley Online Library, and ClinicalTrials.gov to identify the latest 20 years studies comparing ESPB and PVB in breast cancer surgery was conducted. Our endpoints were: intraoperative fentanyl consumption, total postoperative morphine, and time to first analgesic request. Result :A total of 6 studies (394 patients) were included for this meta-analysis. The pooled analysis showed there is -3.03 (MD = -3.03: 95% CI: -7.47– 1.42) mean difference with insignificant overall effect (P = 0.18) for intraoperative fentanyl consumption on ESPB patient after breast cancer surgery compared against PVB procedure. There is an insignificant between ESPB and PVB regarding total postoperative morphine with 0.46 (MD = 0.46: 95% CI: -0.94 – 1.85) mean difference with insignificant overall effect (P =0.52). There is a significant difference between ESPB and PVB regarding time to first analgesic request with 0.23(MD = 0.23: 95% CI: 0.01– 0.44) risk ratio with statistically significant overall effect (P = 0.04). Both intraoperative fentanyl consumption and total postoperative morphine consumption showed heterogeneity. Meanwhile, time to the first analgesic request showed no heterogeneity. Conclusion : PVB is superior to ESPB regarding time to first analgesic request, but ESPB can serve as analternative to PVB with a similar analgesic effect   
Co-Authors Doso Sutiyono Intan Karmila Ismini Aufakamilia