Erector Spinae plane block for analgesia in patients with acute pancreatitis: a scoping review

Background: Acute pancreatitis is a common cause of emergency department presentation for acute abdominal pain, often requiring significant opioid analgesia use. There is emerging evidence that the use of opioid-sparing analgesia alternatives may improve clinical outcomes. Erector spinae plane block (ESPB) is a recently developed peripheral nerve block that has shown efficacy in pain control for rib fractures and post-thoracic procedures. Its use in acute pancreatitis remains poorly characterised and under-explored. Objectives: The primary objective of this scoping review is to assess the safety and efficacy outcomes, including reduction in pain scores and use of additional opioid analgesia, for adult patients undergoing erector spinae plane block for the management of acute pancreatitis pain. Methods: A scoping review of the literature was conducted across Emcare, CENTRAL, Embase, Medline and Cochrane databases. Articles evaluating the efficacy and safety of ESPB for analgesia in patients with confirmed acute pancreatitis were included. Results: Seven studies were included in the scoping review; two randomised control trials, one case series and four case reports. All studies reported on a numerical rating scale as a primary outcome and found a statistically significant reduction in pain scores pre- and post-ESPB. Six studies reported on time to rescue analgesia post ESPB and one study reported on patient satisfaction. All studies reported no major complications or side-effects from the use of ESPB. Conclusion: Overall, all studies included in this scoping review described successful use of ESPB in acute pancreatitis.