Ultrasound guided erector spinae plane block reduces postoperative opioid consumption following breast surgery: A randomized controlled study

Abstract

Study objective: To evaluate the analgesic effect of ultrasound-guided erector spinae plane (ESP) block in breast cancer surgery.

Design: Randomized controlled, single-blinded trial.

Setting: Operating room.

Patients: Fifty ASA I-II patients aged 25-65 and scheduled for elective breast cancer surgery were included in the study.

Interventions: Patients were randomized into two groups, ESP and control. Single-shot ultrasound (US)-guided ESP block with 20 ml 0.25% bupivacaine at the T4 vertebral level was performed preoperatively to all patients in the ESP group. The control group received no intervention. Patients in both groups were provided with intravenous patient-controlled analgesia device containing morphine for postoperative analgesia.

Measurements: Morphine consumption and numeric rating scale (NRS) pain scores were recorded at 1, 6, 12 and 24 h postoperatively.

Main results: Morphine consumption at postoperative hours 1, 6, 12 and 24 decreased significantly in the ESP group (p < 0.05 for each time interval). Total morphine consumption decreased by 65% at 24 h compared to the control group (5.76 ± 3.8 mg vs 16.6 ± 6.92 mg). There was no statistically significant difference between the groups in terms of NRS scores.

Conclusions: Our study findings show that US-guided ESP block exhibits a significant analgesic effect in patients undergoing breast cancer surgery. Further studies comparing different regional anesthesia techniques are needed to identify the optimal analgesia technique for this group of patients.

Keywords: Breast surgery; Erector spinae plane block; Postoperative analgesia; Ultrasound guidance.