Amir S, Siddiqui AH, Haris M, Laique F, Amini B, Mehboob M, Mohiuddin M, Azam MM, Mukhtar S, Akram Z, Zainab B, Rizwan S, Moeed A, Surani S. Ultrasound-guided erector spinae plane block for perioperative analgesia in laparoscopic nephrectomy: A systematic review and meta-analysis. World J Nephrol 2025; 14(4): 110268 [DOI: 10.5527/wjn.v14.i4.110268]
Corresponding Author of This Article
Abdul Hannan Siddiqui, Researcher, Department of Internal Medicine, Dow University of Health Sciences, Mission Road, Karachi 74200, Sindh, Pakistan. hannanabdul1998@outlook.com.
Research Domain of This Article
Urology & Nephrology
Article-Type of This Article
Meta-Analysis
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 25, 2025 (publication date) through Dec 23, 2025
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Publication Name
World Journal of Nephrology
ISSN
2220-6124
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Amir S, Siddiqui AH, Haris M, Laique F, Amini B, Mehboob M, Mohiuddin M, Azam MM, Mukhtar S, Akram Z, Zainab B, Rizwan S, Moeed A, Surani S. Ultrasound-guided erector spinae plane block for perioperative analgesia in laparoscopic nephrectomy: A systematic review and meta-analysis. World J Nephrol 2025; 14(4): 110268 [DOI: 10.5527/wjn.v14.i4.110268]
World J Nephrol. Dec 25, 2025; 14(4): 110268 Published online Dec 25, 2025. doi: 10.5527/wjn.v14.i4.110268
Ultrasound-guided erector spinae plane block for perioperative analgesia in laparoscopic nephrectomy: A systematic review and meta-analysis
Suhaina Amir, Abdul Hannan Siddiqui, Muhammad Haris, Fatima Laique, Bushra Amini, Mariam Mehboob, Mubashir Mohiuddin, Muhammad Mazhar Azam, Sameen Mukhtar, Zainab Akram, Bibi Zainab, Sahar Rizwan, Abdul Moeed, Salim Surani
Suhaina Amir, Abdul Hannan Siddiqui, Muhammad Haris, Fatima Laique, Bushra Amini, Mariam Mehboob, Mubashir Mohiuddin, Muhammad Mazhar Azam, Sameen Mukhtar, Abdul Moeed, Department of Internal Medicine, Dow University of Health Sciences, Karachi 74200, Sindh, Pakistan
Zainab Akram, Sahar Rizwan, Department of Internal Medicine, Jinnah Sindh Medical University, Karachi 75510, Sindh, Pakistan
Bibi Zainab, Department of Internal Medicine, Mekran Medical College, Turbat, Turbat 93000, Balochistan, Pakistan
Salim Surani, Department of Medicine and Pharmacology, Texas A&M University, College Station, TX 77843, United States
Co-first authors: Suhaina Amir and Abdul Hannan Siddiqui.
Author contributions: Amir S contributed to the meta-regression and manuscript writing, including the sensitivity analysis, meta-regression, discussion, and conclusion; Siddiqui AH contributed to the overall coordination and manuscript review; Haris M and Laique F contributed to data analysis; Amini B contributed to manuscript writing (Introduction and Methods); Mehboob M contributed to manuscript writing (Results); Mohiuddin M and Azam MM contributed to data extraction; Mukhtar S contributed to quality assessment, PRISMA, and preparation of the supplementary file; Akram Z, Zainab B, and Rizwan S contributed to data collection and screening; Moeed A contributed to manuscript review and revisions; Surani S contributed to conceptual supervision, final review, and critical revision of the manuscript; all authors contributed to the development and completion of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abdul Hannan Siddiqui, Researcher, Department of Internal Medicine, Dow University of Health Sciences, Mission Road, Karachi 74200, Sindh, Pakistan. hannanabdul1998@outlook.com.
Received: June 4, 2025 Revised: July 16, 2025 Accepted: October 28, 2025 Published online: December 25, 2025 Processing time: 202 Days and 18.7 Hours
Abstract
BACKGROUND
Laparoscopic nephrectomy is a preferred surgical approach due to its minimally invasive nature and faster recovery times. However, effective management of postoperative pain remains a significant challenge. Several traditional methods, including opioid-based analgesia, are commonly used but are associated with side effects such as nausea, vomiting, sedation, and delayed recovery. In recent years, the erector spinae plane block (ESPB) has gained attention as an ultrasound-guided regional anesthesia technique offering promising results in various surgical procedures by reducing opioid requirements and enhancing patient comfort.
AIM
To evaluate the efficacy and safety of ESPB in comparison to conventional pain management strategies in patients undergoing laparoscopic nephrectomy.
METHODS
Following PRISMA guidelines, we searched PubMed, EMBASE, Web of Science, and the Cochrane Register for randomized controlled trials (RCTs) comparing ESPB with control for laparoscopic nephrectomy. The Cochrane Risk of Bias tool was employed for quality assessment. The primary outcome was total patient-controlled analgesia (PCA) consumption. Secondary outcomes included hospital discharge time and the incidence of postoperative nausea and vomiting. A random-effects meta-analysis was conducted to calculate pooled mean differences (MD) and odds ratios (OR) with 95%CIs.
RESULTS
Nine RCTs involving a total of 643 patients (ESPB group = 320; control group = 323) were included in the analysis. ESPB significantly reduced PCA opioid consumption compared to controls (MD: -14.24, 95%CI: -20.66 to -7.83, P < 0.0001). Subgroup analysis showed reduced PCA use with ESPB vs morphine (MD: -8.78, 95%CI: -15.34 to -2.22, P = 0.009), and a non-significant effect compared to other analgesics (MD: -48.26, 95%CI: -143.60 to 47.09). No statistically significant differences were observed in discharge time or the incidence of nausea and vomiting.
CONCLUSION
ESPB demonstrates the potential of reducing PCA in laparoscopic nephrectomy patients; however, its impact on secondary outcomes remains inconclusive. Large-scale RCTs are needed to confirm ESPB's benefits and explore long-term effects.
Core Tip: Erector spinae plane block (ESPB) demonstrates significant efficacy in reducing postoperative opioid use following laparoscopic nephrectomy, highlighting its potential as a promising alternative for enhanced pain management. While ESPB shows promise in lowering patient-controlled analgesia requirements compared to traditional methods, its impact on discharge times and nausea/vomiting remains inconclusive. Future large-scale randomized controlled trials are crucial to validate these findings and explore ESPB's long-term benefits in optimizing recovery pathways for nephrectomy patients.
