Efficacy and Safety of Erector Spinae Plane Block versus Thoracolumbar Interfascial Plane Block in Patients Undergoing Spine Surgery

Objectives: As two novel peripheral nerve blocks, the erector spinae plane block (ESPB) and thoracolumbar interfascial plane (TLIP) block can relieve postoperative pain in spinal surgery. This systematic review and meta-analysis aimed to determine the efficacy and safety of ESPB versus TLIP block in patients undergoing spine surgery. Methods: An extensive search of English online databases, including PubMed, Web of Sciences, Embase, Medline and Cochrane Central Register of Controlled Trials and Chinese online databases like Wanfang Data, CNKI and CQVIP until March 31, 2023, with no language restrictions was performed. This systematic review and meta-analysis are based on the PRISMA statement and has been registered on PROSPERO (International Prospective Register of Systematic Reviews) with registered ID: CRD42023420987. Results: Five studies involving 457 patients were eligible for this study. Compared with TLIP block, ESPB had lower postoperative opioid consumption at postoperative 48 hours (SMD=−1.31, 95% CI=−2.54 to −0.08, P =0.04, I 2 =80%) and postoperative pain score at postoperative 24 hours (SMD=−0.72, 95% CI=−1.43 to −0.02, P =0.04, I 2 =95%) in patients undergoing spine surgery. Complications associated with ESPB and TLIP block were not reported in the included studies. Discussion: ESPB and TLIP block are two novel and effective block methods. Patients receiving ESPB had lower postoperative opioid consumption and postoperative pain score compared with patients receiving TLIP block, there was no significant difference between the two groups in intraoperative opioid consumption, adverse events and rescue analgesia.