Efficacy and safety of erector spinae plane block for postoperative analgesia after surgery: An Umbrella review protocol

Background: Poorly managed postoperative pain after thoraco-abdominal surgery has several consequences in the postoperative period. The postoper ative pain after thoraco-abdominal surgery has been managed with systemic opioids and different regional anesthesia techniques. The opioid-based analgesics and landmark techniques have undesirable consequences; regional analgesia tech nique with ultrasound requires resources and expertise, while erector spinae plane block is a new technique with minimal side effects and is easy to administer. However, the quality of evidence on its efficacy is still uncertain and needs further investigation. Objective: This systematic review aimed to provide the quality of evidence on the efficacy and safety of erector spinae block after surgery. Method: A comprehensive search was conducted in PubMed/Medline, Cochrane, Science Direct, CINHAL, and LILACS without date and language restrictions. All randomized trials comparing the efficacy of wound infiltration for postoperative pain management after cesarean section were included while observational studies and reviews were excluded. The data was extracted with two independent authors in a customized format. The methodological quality of the included studies was evaluated using a Measurement Tool to assess systematic Reviews (AMSTAR). The overall quality of the evidence was determined by GRADEpro software. The systematic review was conducted in line with the preferred Reporting Items of systematic review and meta-analysis (PRISMA). Discussion: The incidence of postoperative pain after thoraco-abdominal surgery is very high, which has a severe impact on the patient, family, healthcare providers, and healthcare delivery. This systematic review aimed to provide quality evidence on the efficacy and safety of landmark and ultrasound-assisted erector spinae plane block technique for postoperative pain management after surgery. Keywords: Analgesia, Erector spinae, Paravertebral, Postoperative