Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Sep 19.
doi: 10.1002/wjs.70105. Online ahead of print.

Efficacy and Safety of Erector Spinae Plane Block in Pain Management for Inguinal Hernia Repair: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Zain Ali Nadeem  1 , Aqsa Zainab  1 , Armaghan Ur Rehman  1 , Ariba Fida  1 , Maha Malik  1 , Neha Malik  1 , Saad Nadeem  1 , Muhammad Hussnain Bin Asif  1 , Nisa Kapoor Sheikh  1 , Muhammad Hamza Shoaib  1 , Nouman Amjad  1 , Aimen Nadeem  2 , Abdulqadir J Nashwan  3 , Muhammad Ahmad Nadeem  4 , Amir Humza Sohail  5
Affiliations
Review

Efficacy and Safety of Erector Spinae Plane Block in Pain Management for Inguinal Hernia Repair: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

Zain Ali Nadeem et al. World J Surg. .

Abstract

Background: Erector spinae plane block (ESPB) is a new anesthetic technique, but its use in inguinal hernia repair remains a subject of debate. We aim to determine the efficacy and safety of ESPB in reducing postoperative pain in inguinal hernia repair in adults.

Methods: We searched MEDLINE, Science Direct, Embase, CENTRAL, ClinicalTrials.gov, and WHO ICTRP for all relevant randomized controlled trials (RCTs) using ESPB in inguinal hernia repair. Two reviewers independently screened the studies, with a third resolving disputes. Risk of bias was assessed using the Cochrane RoB 2 tool. Data were analyzed on R version 4.4.1, using risk ratios (RRs) for dichotomous and mean differences (MDs) for continuous outcomes with 95% confidence intervals (CIs).

Results: Meta-analysis of 6 RCTs revealed no significant reduction in postoperative pain with ESPB at rest or with movement at any time point nor did it significantly lower 24-h opioid consumption. However, in subgroup analysis, ESPB reduced the pain at rest at 12 h in the intraoperative subgroup (p < 0.01) and the 24-h opioid consumption in the intraoperative and the laparoscopic subgroups (p = 0.02). ESPB did not differ significantly from control in time to first rescue analgesia and proportion of patients requiring rescue analgesia. ESPB was not associated with nausea, vomiting, or urinary retention. One study was at high risk of bias, one with some concern, and four at low risk.

Conclusions: ESPB reduces opioid consumption following laparoscopic inguinal hernia repair, but the pain reduction is not clinically significant and the efficacy in open repair is uncertain.

Keywords: anesthesia; erector spinae plane block; fascial plane block; herniorrhaphy; inguinal hernia; pain.

PubMed Disclaimer

References

    1. M. S. Abebe, A. A. Tareke, A. Alem, W. Debebe, and A. Beyene, “Worldwide Magnitude of Inguinal Hernia: Systematic Review and Meta‐Analysis of Population‐Based Studies,” SAGE Open Medicine 10 (2022): 20503121221139150, https://doi.org/10.1177/20503121221139150.
    1. F. Wang, B. Ma, Q. Ma, and X. Liu, “Global, Regional, and National Burden of Inguinal, Femoral, and Abdominal Hernias: A Systematic Analysis of Prevalence, Incidence, Deaths, and DALYs With Projections to 2030,” International Journal of Surgery 110, no. 4 (2024): 1951–1967, https://doi.org/10.1097/JS9.0000000000001071.
    1. R. J. Fitzgibbons and R. A. Forse, “Groin Hernias in Adults,” New England Journal of Medicine 372, no. 8 (2015): 756–763, https://doi.org/10.1056/NEJMcp1404068.
    1. N. Haladu, A. Alabi, M. Brazzelli, et al., “Open Versus Laparoscopic Repair of Inguinal Hernia: An Overview of Systematic Reviews of Randomised Controlled Trials,” Surgical Endoscopy 36, no. 7 (2022): 4685–4700, https://doi.org/10.1007/s00464‐022‐09161‐6.
    1. M. Nishikawa, T. Fukuda, and M. Okazaki, “Predictive Factors of Postoperative Acute Pain in Laparoscopic Inguinal Hernia Repair in Men: A Single‐Centre Retrospective Study in Japan,” Journal of Perioperative Practice 33, no. 5 (2023): 133–138, https://doi.org/10.1177/17504589211054371.

Grants and funding

LinkOut - more resources