Evidence map›Paper›PMID 42096123›Full record

SynthesisObesity surgery2026

Efficacy of Erector Spinae Block on Postoperative Outcomes in Bariatric Surgery Patients: A Systematic Review, Meta-Regression, and Trial-Sequential Analysis of Randomized Controlled Trials.

Vitaliy Voznyy, Salem Abu Al-Burak, Yamini Subramani, Mouad Elganga, Alla Iansavitchene, Lee-Anne Fochesato, Priyanka Singh, Harley Williams, Christopher Harle, Mahesh Nagappa

Abstract readSystematic ReviewMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Obesity surgery, 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

10 authors.

Vitaliy Voznyy *Temerty Faculty of Medicine, University of Toronto, Ontario, Toronto, M5S 3K3, Canada.ORCID http://orcid.org/0009-0002-6501-6196
Salem Abu Al-Burak *Department of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, Ontario, N6A 5A5, Canada.ORCID http://orcid.org/0000-0002-4044-3215
Yamini SubramaniDepartment of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, Ontario, N6A 5A5, Canada.ORCID http://orcid.org/0000-0002-2050-4324
Mouad ElgangaTemerty Faculty of Medicine, University of Toronto, Ontario, Toronto, M5S 3K3, Canada.ORCID http://orcid.org/0009-0008-2243-1916
Alla IansavitcheneHealth Science Library, London Health Sciences Centre, London, Ontario, N6A 5A5, Canada.ORCID http://orcid.org/0000-0002-5651-1024
Lee-Anne FochesatoDepartment of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, Ontario, N6A 5A5, Canada.ORCID http://orcid.org/0000-0001-7751-098X
Priyanka SinghDepartment of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, Ontario, N6A 5A5, Canada.ORCID http://orcid.org/0009-0003-4981-9586
Harley WilliamsDepartment of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, Ontario, N6A 5A5, Canada.ORCID http://orcid.org/0000-0001-5331-452X
Christopher HarleDepartment of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, Ontario, N6A 5A5, Canada.ORCID http://orcid.org/0000-0003-2784-3924
Mahesh NagappaDepartment of Anesthesia and Perioperative Medicine, London Health Sciences Centre and St. Joseph Health Care, Schulich School of Medicine and Dentistry, Western University, London, Ontario, N6A 5A5, Canada. Mahesh.Nagappa@lhsc.on.ca.ORCID http://orcid.org/0000-0001-8036-3319

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBariatric surgery is effective for severe obesity, but recovery is often complicated by pain, nausea, and high opioid use. This systematic review and meta-analysis (SRMA) evaluates the role of erector spinae plane block (ESPB) in reducing pain, opioid consumption, and postoperative nausea and vomiting (PONV) after bariatric surgery.

methodsElectronic databases were systematically searched from their inception to March 2025 for randomized controlled trials (RCTs) assessing bilateral ESPB in adults undergoing bariatric surgery. This review included studies which compared ESPB to a control group and reported at least one postoperative outcome. The primary outcome was resting pain at 6 h and 24 h. The mean difference (MD) and 95% confidence interval (CI) were calculated for each study and pooled using a random-effects model. The meta-regression and trial sequential analysis were performed to evaluate the impact of confounding variables and sample size on the pooled estimate. The risk of bias and certainty of evidence were assessed using the Cochrane Risk of Bias 2 (RoB 2) and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessment tools.

resultsTwelve RCTs (n = 825; ESPB = 412, control = 413) were included. ESPB significantly reduced resting pain at 6 h (MD: 1.79; 95% CI: 0.80 - 2.78; p = 0.0004) and 24 h (MD: 1.09; 95% CI: 0.38-1.79; p = 0.002). Six RCTs (n = 509) reported lower movement-evoked pain at 6 h (MD:1.28; 95% CI: 0.68-1.88; p < 0.0001) and 24 h (MD: 0.79; 95% CI: 0.44-1.14; p < 0.0001). Nine RCTs (n = 673) showed reduced 24-h opioid consumption (MD: 9.0; 95% CI: 2.72 to 15.27, P = 0.005). Five RCTs (n = 448) reported a lower incidence of PONV with ESPB (Risk Ratio: 1.47; 95% CI: 1.08-1.98, p = 0.01). Meta-regression to adjust for baseline confounding factors and trial sequential analysis did not materially alter the results. The risk of bias was low, and the certainty of evidence was rated as moderate to low.

conclusionThis SRMA of RCTs demonstrates that ESPB may significantly reduce postoperative pain, 24-h postoperative opioid consumption, and PONV compared to control in patients undergoing bariatric surgery. However, further RCTs with adequate power, unified protocols, and clearly defined endpoints are warranted.

Indexed as

Bariatric SurgeryNerve BlockObesity, MorbidParaspinal MusclesPostoperative Nausea and VomitingPostoperative PainAnalgesics, OpioidHumansRandomized Controlled Trials as TopicTreatment OutcomeAnalgesics, OpioidErector spinae blockLaparoscopic bariatric surgeryMet. analysisOpioid consumptionPostoperative Nausea and VomitingPostoperative outcomesPostoperative pain

Identifiers

PMID42096123

What Socratic holds

Textmetadata
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.