Publication: Analgesic efficacy and opioid sparing effect of erector spinae planeblock in oncologic breast surgery: An observational study
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Date
2022-03-01
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Abstract
Background/Aim: Erector spinae plane block (ESPB) is a fascial plane block technique suitable for
perioperative analgesia. This study aimed to evaluate the value of ESPB performed under ultrasound
guidance and with ANI (Analgesia Nociception Index) monitoring in terms of intraoperative opioid need
and postoperative pain management, in patients undergoing oncological breast surgery.
Methods: This prospective case-control study includes forty-two female breast cancer patients who
underwent unilateral modified radical mastectomy with axillary lymph node dissection. Patients were
allocated to receive (ESPB group) or not receive (controls) ultrasound guided ESPB before anesthesia
induction based on patient preference, and the groups were compared in terms of total intraoperative
opioid consumption (with the guidance of ANI) and postoperative pain. Visual analogue scores (VAS)
were obtained during the 12-hour postoperative follow-up.
Results: Total intraoperative remifentanil dose required was significantly lower in the ESPB group when
compared to controls (361.9 (108.3) vs. 1560.0 (4), P<0.001). ESPB group had significantly lower visual
analogue scores at all postoperative time points. None of the patients in the ESPB group but all controls
required additional analgesia during the 12-hour postoperative follow-up period.
Conclusion: Ultrasound guided ESPB together with ANI monitoring is an effective and relatively safe
perioperative analgesia method in patients undergoing mastectomy. Together, they provide an effective
postoperative analgesia and reduce intraoperative opioid use consumption. Further studies will shed more
light on the role of ESPB in this setting.
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Keywords
Erector spinae plane block (ESPB), Oncological breast surgery, Perioperative pain, Opioid
Citation
ORHON ERGÜN M., ZENGİN S. Ü., mustafayeva a., UĞURLU M. Ü., UMUROĞLU T., "Analgesic efficacy and opioid sparing effect of erector spinae plane
block in oncologic breast surgery: An observational study", journal of surgery and medicine, cilt.6, sa.3, ss.351-355, 2022