A Comparative Study between Erector Spinae Plane Block with General Anesthesia versus Conventional Intravenous Analgesics with General Anesthesia in Patients undergoing Conserving Surgery for Breast Cancer

Abstract

Background Acute pain is a common concern after breast surgery, and despite the conventional management of pain with different analgesics, many patients have poor responses. Paravertebral, epidural, pectoral and serratus plane blocks are the regional blocks, which are used commonly to control pain after breast surgeries. Each of these techniques has its advantages and disadvantages. Erector spinae plane block (ESPB) is a new regional approach which can provide analgesia to the chest wall, by which local anesthetic drugs can be deposited in the plane between erector spinae muscle and the transverse process producing hemithoracic analgesia. This study was intended to assess the efficacy of ESPB for postoperative analgesia after breast surgeries.Results Fifty-four patients were enrolled in this study and divided into two groups, 27 patients in each group. Group B patients received general anesthesia with ESPB and group C patients received general anesthesia with conventional intravenous analgesia. Group B showed statistically significant reduction in total opioid consumption at 24 hours postoperatively, lower VAS score and improved hemodynamic parameters in the first 8 hours postoperatively.Conclusions Ultrasound-guided ESPB performed at the level of T5 was found to be effective and safe in controlling postoperative pain after breast surgery.

Keywords

• Acute postoperative pain
• erector spinae plane block
• postoperative analgesia after breast surgery