Erector spinae plane block versus intercostal nerve block for postoperative analgesia: a protocol for systematic review and meta-analysis

Abstract

Introduction: An increasing number of randomised controlled trials (RCTs) have compared the analgesic effects of erector spinae plane block with those of intercostal nerve block for postoperative analgesia in various surgeries, but the results have been inconsistent. This protocol of a systematic review and meta-analysis aims to evaluate whether the analgesic effects of erector spinae plane block are superior to those of intercostal nerve block.

Methods and analysis: A comprehensive search will be conducted by two authors via PubMed, EMBASE, the Cochrane Library and Web of Science from inception to 25 December 2025. No search language restrictions will be set. We will include RCTs that compared the analgesic effects of erector spinae plane block with those of intercostal nerve block after surgery. Total opioid consumption over 24 hours postoperatively will be the primary outcome. The duration of analgesia, pain intensity and incidence of adverse effects will be the secondary outcomes. RevMan V.5.4 software will be used to conduct the statistical analysis. The Cochrane Collaboration's tool will be used to assess the risk of bias. The I² test will be used to assess heterogeneity. Subgroup analysis and meta-regression will be performed to explore the source of heterogeneity. Sensitivity analysis will be used to examine the reliability of the pooled data. The Grading of Recommendations Assessment, Development and Evaluation approach will be used to recommend evidence quality. Publication bias will be evaluated via Egger's test.

Ethics and dissemination: Ethical approval is not applicable. The results will be publicly published on completion.

Prospero registration number: CRD420251073023.

Keywords: Adult anaesthesia; Meta-Analysis; PAIN MANAGEMENT.

Figure 1. The flow diagram of study selection. n, number of studies.