Efficacy of ultrasound-guided erector spinae plane block on postoperative quality of recovery and analgesia after modified radical mastectomy: randomized controlled trial

• Published in: Regional anesthesia and pain medicine Vol. 45; no. 1; pp. 5 - 9
• Main Authors: Yao, Yusheng, Li, Hao, He, Qiaolan, Chen, Tingting, Wang, Yihang, Zheng, Xiaochun
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.01.2020; Copyright by American Society of Regional Anesthesia and Pain Medicine; BMJ Publishing Group LTD
• Subjects: acute pain; Airway management; Analgesics; Blood pressure; Breast cancer; Cancer surgery; General anesthesia; interventional pain management; Local anesthesia; Mastectomy; Medical personnel; Original article; Pain; Patients; postoperative pain; Postoperative period; Questionnaires; Recovery (Medical); Regional anesthesia; truncal blocks; Ultrasonic imaging; interventional pain management; acute pain; postoperative pain; truncal blocks
• ISSN: 1098-7339; 1532-8651
• DOI: 10.1136/rapm-2019-100983

BackgroundErector spinae plane block (ESPB) is a novel regional anesthesia technique that is gaining popularity for postoperative pain management. This randomized controlled trial evaluated the effect of ESPB on quality of recovery (QoR) in patients undergoing modified radical mastectomy.MethodsEighty-two female patients undergoing modified radical mastectomy were included. Patients were randomly assigned to receive preoperative ultrasound-guided ESPB with either 0.5% ropivacaine or saline. The primary outcome was QoR, assessed 24 hours postoperatively using the 15-item QoR questionnaire (QoR-15). Secondary outcomes included postoperative pain scores, postoperative cumulative opioid consumption, postanesthesia care unit (PACU) discharge time, postoperative nausea or vomiting and dizziness.ResultsGlobal QoR-15 scores 24 hours postoperatively were significantly higher (indicating better quality) in the ESPB group (median 120, IQR 118–124) compared with the control group (median 110, IQR 108.3–112.8), with a median difference of 10 (95% CI 9 to 12, p<0.001). Compared with the control group, ESPB with ropivacaine reduced pain scores up to 8 hours after surgery, as well as reduced postoperative cumulative opioid consumption and PACU discharge time.ConclusionsA single preoperative injection of ESPB with ropivacaine may improve QoR postoperatively and acute postoperative analgesia in patients undergoing a modified radical mastectomy.Trial registration numberChiCTR-1800019599.