Methodological quality of systematic reviews on the erector spinae plane block: A systematic review - 22/02/26
, Yunus Emre Karapinar b, Muzeyyen Beldagli c, Engin İhsan Turan d, Esra Turunc a, Elif Sarikaya Ozel e, Cengiz Kaya a, Madan Narayanan f, Alessandro De Cassai g, hHighlights |
• | The ESP block has been widely studied in numerous published meta-analyses. |
• | The methodological quality of these reviews has not yet been assessed comprehensively. |
• | Over 80% of the ESP block meta-analyses were rated as low or critically low-quality. |
• | Common flaws include missing bias assessments, excluded study lists, and funding disclosures. |
• | No clear predictors of the methodological quality were identified. |
• | These findings highlight the need for improved methodological rigor in future studies. |
• | Editors and authors should align with the AMSTAR-2 standards. |
Abstract |
Background |
The number of meta-analyses (MAs) evaluating the erector spinae plane (ESP) block has increased rapidly; however, their methodological quality remains uncertain.
Methods |
A systematic search was conducted in PubMed, Embase, Scopus, Web of Science, and the Cochrane Library for ESP block MAs published from 2016 to 2025. Methodological quality was assessed using the AMSTAR-2 tool, whereas study overlap across reviews was quantified using the corrected covered area (CCA). Multivariate analyses were used to explore the potential predictors of quality.
Findings |
Ninety-seven MAs were included. Most evaluated single-injection techniques (91.8%) in adults (87.6%), predominantly thoracic-level blocks (48.5%), and abdominal surgeries (33%). Based on AMSTAR-2, 7 reviews (7.2%) were high quality, 9 (9.3%) were moderate, 41 (42.3%) were low, and 40 (41.2%) were critically low quality. Frequent deficiencies included missing funding statements (98%), absence of excluded study lists (40%), and inadequate assessment of publication bias. Across all reviews, 1214 randomized trials were identified, of which 571 were unique (CCA: 1.17%). No significant predictors of the methodological quality were identified.
Conclusions |
Although the ESP block is widely supported by existing literature, the methodological quality of most MAs remains suboptimal. Improved adherence to established reporting and appraisal standards is required to support reliable clinical decision-making.
PROSPERO registration number |
CRD420251081933.
Le texte complet de cet article est disponible en PDF.Abbreviations : MAs, ESP, SMD, MD, AMSTAR-2
Keywords : Meta-analysis, Erector spinae plane block, Nerve block
Plan
Vol 45 - N° 4
Article 101766- juillet 2026 Retour au numéro
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