A Randomized Clinical Study to Compare the Perioperative Analgesic Efficacy of Ultrasound-Guided Erector Spinae Plane Block Over Thoracic Epidural in Modified Radical Mastectomy

Aim This study aims to compare the effectiveness of ultrasound-guided erector spinae block (ESB) with thoracic epidural (TE) in managing postoperative pain among breast cancer (BC) surgery patients. Methods A total of 42 patients were enrolled and randomly divided into two groups, each comprising 21...

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Published in:Curēus (Palo Alto, CA) CA), 2023-12, Vol.15 (12), p.e51103-e51103
Main Authors: R, Deepshika, Parameswari, Aruna, Venkitaraman, Balasubramanian, Vakamudi, Mahesh, Manickam, Akilandeswari
Format: Article
Language:English
Subjects:
Analgesics
Anesthesiology
Blood pressure
Breast cancer
Breast surgery
Catheters
Clinical trials
Drug dosages
Epidural
Extubation
Fentanyl
Heart rate
Hemodynamics
Mastectomy
Narcotics
Nonsteroidal anti-inflammatory drugs
Normal distribution
Oncology
Pain
Pain Management
Patients
Regional anesthesia
Statistical analysis
Thrombocytopenia
Ultrasonic imaging
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Summary:Aim This study aims to compare the effectiveness of ultrasound-guided erector spinae block (ESB) with thoracic epidural (TE) in managing postoperative pain among breast cancer (BC) surgery patients. Methods A total of 42 patients were enrolled and randomly divided into two groups, each comprising 21 participants. Primary endpoints assessed included intraoperative fentanyl consumption, postoperative pain scores, and the need for rescue analgesia. Secondary endpoints encompassed intraoperative hemodynamic changes and the incidence of postoperative nausea and vomiting (PONV). Results The study found no significant difference in intraoperative fentanyl requirement (p=0.62) or postoperative pain scores measured using numerical rating scores (NRS) throughout the 48-hour postoperative period. None of the patients in either group required rescue analgesia. Notably, there was a statistically significant difference in postoperative nausea and vomiting at the two-hour mark, favoring the erector spinae block. Both groups exhibited comparable hemodynamic changes during intraoperative monitoring. Conclusions Our investigation concludes that the ESF offers equivalent analgesic efficacy to the thoracic epidural during both surgery and the postoperative period without inducing any significant hemodynamic instability. Considering the lower complication rate associated with paraspinal blocks compared to neuraxial blocks, the ESB presents itself as a promising alternative method for effective pain relief in mastectomy procedures.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.51103