Bajpai Shalini, Kumar K Shiv, Patibandla Swetha, Giridhar C M
Department of Anesthesia, Critical Care and Pain, Homi Bhabha Cancer Hospital and Research Centre (A Unit of Tata Memorial Centre, Mumbai), Visakhapatnam, Andhra Pradesh, India.
Department of Surgical Oncology, Homi Bhabha Cancer Hospital and Research Centre (A Unit of Tata Memorial Centre, Mumbai), Visakhapatnam, Andhra Pradesh, India.
Saudi J Anaesth. 2023 Jul-Sep;17(3):327-333. doi: 10.4103/sja.sja_760_22. Epub 2023 Jun 22.
Erector spinae plane (ESP) block provides postoperative analgesia in breast surgeries but has limited duration of action that restricts its efficacy to early postoperative period. This study aims to evaluate the analgesic efficacy and opioid sparing effect of ultrasound (US)-guided continuous erector spinae plane (CESP) block in perioperative period in breast cancer surgery.
Fifty ASA I/II patients aged more than 18 years, scheduled for elective breast cancer surgery were randomized to either Group B (Block group) or Group C (Control group). Patients in group B received US-guided CESP block, whereas patients in group C did not receive the block prior to general anesthesia. The primary outcome of this study was to measure total tramadol consumption in 24 h postsurgery. Intraoperative fentanyl consumption, pain scores, postoperative nausea/vomiting, and patient satisfaction score at discharge were also recorded.
Total tramadol consumption was 94.6% lower in the block group as compared to the control group (5.4 ± 18.7 mg in CESP block group as compared to 99.7 ± 49.6 mg in control group). Intraoperative fentanyl requirement and pain scores were significantly lower in CESP group. Postoperative incidence of nausea/vomiting was similar, but satisfaction score was significantly better in block group.
US-guided CESP block provides effective and prolonged peri operative analgesia and opioid sparing in breast cancer surgeries.
竖脊肌平面（ESP）阻滞可在乳腺手术中提供术后镇痛，但作用持续时间有限，限制了其在术后早期的疗效。本研究旨在评估超声（US）引导下连续竖脊肌平面（CESP）阻滞在乳腺癌手术围手术期的镇痛效果和阿片类药物节省效应。
50例年龄超过18岁、计划行择期乳腺癌手术的ASA I/II级患者被随机分为B组（阻滞组）和C组（对照组）。B组患者接受US引导下的CESP阻滞，而C组患者在全身麻醉前未接受该阻滞。本研究的主要结局是测量术后24小时曲马多的总消耗量。还记录了术中芬太尼消耗量、疼痛评分、术后恶心/呕吐情况以及出院时的患者满意度评分。
与对照组相比，阻滞组曲马多总消耗量降低了94.6%（CESP阻滞组为5.4±18.7mg，对照组为99.7±49.6mg）。CESP组术中芬太尼需求量和疼痛评分显著更低。术后恶心/呕吐发生率相似，但阻滞组的满意度评分显著更高。
US引导下的CESP阻滞在乳腺癌手术中可提供有效且持久的围手术期镇痛及阿片类药物节省效应。
