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Year : 2021  |  Volume : 65  |  Issue : 5  |  Page : 377-382

Efficacy of ultrasound-guided erector spinae plane block following breast surgery - A double-blinded randomised, controlled study

Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre (Homi Bhabha National Institute), E Borges Road, Parel, Mumbai, Maharashtra, India

Correspondence Address:
Raghu S Thota
Department of Anaesthesiology, Critical Care and Pain, ACTREC, Tata Memorial Centre, Homi Bhabha National Institute, E Borges Road, Parel, Mumbai - 400 012, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ija.IJA_1426_20

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Background and Aims: Regional anaesthesia has been used to reduce acute post-operative pain as well as opioid-related side effects in breast cancer surgery. Erector spinae plane (ESP) block is a relatively new fascial plane block being tried in various surgical procedures. Our study is a double-blind randomised trial, designed to prove the efficacy of this block in breast surgeries. Methods: Seventy female patients scheduled for unilateral breast surgery were enroled in this prospective, randomised, double-blind study. Patients were randomised to group A and group B. All patients received general anaesthesia while group B received additional ultrasound-guided erector spinae block given at thoracic level—T5 with 20ml of 0.25% bupivacaine. Time to first rescue analgesia was the primary outcome. Secondary outcomes were total intraoperative opioid consumption, pain scores over 24 h, post-operative nausea and vomiting and patient satisfaction score at discharge. The Shapiro–Wilk test was used to check the normality of each variable. A comparison was done using Mann–Whitney test and the level of significance was set at 0.05. Results: The median time to first rescue analgesia in group A versus group B was 1 h (1–12h) versus 8 h (1–26h), respectively, with a P value of 0.044. Group B patients had lower pain scores post-operatively and better satisfaction scores at discharge. There was no statistically significant difference in intraoperative fentanyl consumption. Conclusion: Ultrasound-guided ESP block with general anaesthesia offers superior post-operative analgesia compared to general anaesthesia alone in patients undergoing unilateral nonreconstructive breast cancer surgeries.

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