The purpose of this article is to to compare the analgesic effect and adverse reactions of ultrasound-guided retrolaminal block (RLB) and erector spinae plane block (ESPB) in patients undergoing orthopedic surgery by meta-analysis. Rndomized controlled trials (RCTs) comparing the analgesic effects of RLB and ESPB blocks after orthopedic surgery were included by computer searches of PubMed, Embase, Ovid, Web of Science, Cochrane Library, CNKI, Vip Database, Wanfang Database and China Biomedical Full-text Database. The primary outcomes were resting pain scores at 2h, 4h, 6h, 8h, 12h, 24h and 48h postoperatively; Secondary outcomes were perioperative refentanil dosage and adverse effects such as nausea and vomiting, dizziness, and urinary retention. RevMan 5.3 software was used for statistical analysis of the data. Seven RCTs with a total of 487 patients were included, including 249 in the RLB block group and 238 in the ESPB group. The results of meta-analysis showed that compared with ESPB group (control group), the pain score at 2h (MD=-0.36, 95%CI -0.63~-0.09, P<0.05), 12h (MD=0.07, 95%CI 0.01~-0.13, P=0.03), and 24h (MD=0.33, 95%CI 0.24~-0.42, P <0.05) postoperatively and perioperative refentanil consumption were significantly reduced in the RLB group (experimental group). The pain score at 6h postoperatively (MD=0.79, 95% CI 0.65~0.92, P<0.01) was significantly increased in the RLB group (experimental group). There were no significant difference in pain scores at 4h(MD=-0.16, 95%CI -0.52~0.21, P=0.40)and 48h(MD=-0.03, 95%CI -0.19~0.1, P=0.74) postoperatively and in the incidence of adverse reactions such as nausea and vomiting, dizziness and urinary retention between the two groups. The available evidence shows that ultrasound-guided RLB is better than EPSB in postoperative analgesia in orthopedic surgery, and does not increase the occurrence of adverse reactions.

Li Shengnan, Wei Yao, Liang Yu. Meta-Analysis of Ultrasound Guided Posterior Lamina Block and Erector Spinae Muscles Plane Block for Postoperative Analgesia and Adverse Reactions in Orthopedic Surgery. International Journal of Frontiers in Medicine (2023), Vol. 5, Issue 9: 55-63. https://doi.org/10.25236/IJFM.2023.050910.

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