Evidence map›Paper›PMID 41781997›Full record

ReviewJournal of anesthesia, analgesia and critical care2026

Fascial plane blocks in labor: promise or illusion? A narrative review with expert opinion.

Antonio Coviello, Dario Cirillo, Maria Grazia Frigo, Filomena Coppola, Giorgio Ranieri, Domenico Pietro Santonastaso, Paolo Scimia, Giuseppe Servillo

Abstract readReview
In one paragraph

Review in Journal of anesthesia, analgesia and critical care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Antonio CovielloDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131, Naples, Italy.
Dario CirilloDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131, Naples, Italy. dariocirillo3@gmail.com.
Maria Grazia FrigoUOSID, Obstetric Anesthesia and Resuscitation, Isola Tiberina Hospital - Gemelli Isola, 39, 00186, Rome, Italy.
Filomena CoppolaDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131, Naples, Italy.
Giorgio RanieriComplex Operational Unit of Anesthesia and Operating Units, Department of Emergency and Internal Medicine, Isola Tiberina Hospital, Gemelli Isola, 39, 00186, Rome, Italy.
Domenico Pietro SantonastasoAnesthesia and Intensive Care Unit, AUSL Romagna, M. Bufalini Hospital, 47521, Cesena, Italy.
Paolo ScimiaDepartment of Anesthesia and Intensive Care Unit, Giuseppe Mazzini Hospital, 64100, Teramo, Italy.
Giuseppe ServilloDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples "Federico II", 80131, Naples, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNeuraxial analgesia represents the gold standard for labor pain management, providing superior efficacy and safety for both mother and fetus. However, its use is not always feasible due to medical contraindications, technical difficulties, or patient preference. Fascial Plane Blocks (FPBs) have emerged as potential alternatives, yet evidence regarding their effectiveness in labor remains limited. The purpose of this study was to synthesize the current evidence on FPBs for labor analgesia and to offer expert insight into their potential role, benefits, and limitations within modern obstetric practice. MATERIAL AND

methodsA systematic search of PubMed, EMBASE, and the Cochrane Library (1985-2025) was conducted following PRISMA guidelines. Eligible studies included laboring women aged ≥ 18 years undergoing analgesia with FPBs. Case reports, case series, and letters to the editor were included due to the scarcity of high-level evidence. Outcomes of interest were maternal pain scores, analgesic satisfaction, and maternal-fetal safety. Because of the marked heterogeneity in study designs, interventions, and outcome measures, a meta-analysis was not feasible; therefore, a narrative synthesis was performed, and qualitative methodological assessment was undertaken using validated tools.

resultsEight studies met inclusion criteria. QLB demonstrated promising analgesia in the first stage of labor, while lumbar and thoracic ESPBs yielded variable effects and inconsistent coverage during the second stage. Sacral ESPB showed potential as an adjunct when neuraxial techniques failed or were contraindicated. No major complications were reported; however, methodological limitations, small sample sizes, and inconsistent reporting hindered definitive conclusions. Fetal outcomes were rarely reported, and no long-term follow-up data were available.

conclusionsCurrent evidence does not support FPBs as replacements for neuraxial analgesia. Their use should be restricted to highly selected cases where neuraxial techniques are not feasible. Importantly, there is no predefined formula for managing labor pain-analgesic strategies must be individualized according to clinical context, patient preference, and available resources. High-quality prospective studies are necessary to clarify the role of FPBs in labor.

Indexed as

Erector Spinae Plane BlockFascial Plane BlocksLabor AnalgesiaObstetric AnalgesiaReview

Identifiers

PMID41781997
PMCPMC13069772

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.