Alternatives for erector spinae plane block – comparison of retrolaminar block and thoracolumbar interfascial plane block

Backgroud: Erector spinae plane blocks are well-established superficial plane blocks as alternative for conservative paravertebral blocks in post-operative analgesia with lower risk of complications such as pneumothorax. However, the other superficial plane blocks are not fully investigated.

Method: Only RCTs conducted to compare erector spinae plane block (ESPB) with retrolaminar block (RLB) or thoracolumbar interfascial plane block (TLIPB) were included. PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched from inception until November, 2023. Postoperative VAS score in PACU, postoperative morphine equivalent usage, and postoperative nausea/vomitus were assessed.

Results: Comparing ESPB with RLB, RLB group had lower postoperative morphine equivalent usage and  slightly lower postoperative VAS score in PACU. Comparing ESPB with TLIPB, postoperative VAS score in PACU showed no difference between two groups. Postoperative morphine equivalent usage was higher in TLIP group than the ESPB. Both RLB and TLIP had no significant differences on postoperative nausea/vomitus compared to ESPB group.

Conclusion: RLB may serve as a better superficial plane block than ESPB, while TLIPB does not.

Retrolaminar Block may provide better postoperative pain control than Erector Spinae Plane Block, but not Thoracolumbar Interfascial Plane Block