Raborn Macdonald Layne, ElHawary Hassan, Joshi Girish P, Janis Jeffrey E
From the Division of Plastic Surgery, University of Rochester Medical Center, Rochester, NY.
Division of Plastic and Reconstructive Surgery, McGill University, Montréal, Quebec, Canada.
Plast Reconstr Surg Glob Open. 2025 Apr 2;13(4):e6667. doi: 10.1097/GOX.0000000000006667. eCollection 2025 Apr.
In plastic surgery, breast surgery patients are among the most susceptible to postoperative pain. Amidst the opioid epidemic, healthcare goals seek to optimize nonopioid multimodal pain control by including regional analgesia. The erector spinae plane block (ESPB) is among several regional blocks used in breast surgery. Although the paravertebral block has previously served as the gold standard, new research focused on ESPB may shift standards.
A comprehensive PubMed review was performed in September 2023 to identify articles related to ESPB use in breast surgery. Non-English and unavailable articles were excluded. Data extracted included publication year, techniques, and outcomes.
Sixty-eight publications were included, of which 31 were randomized control trials (45.6%). Most were published between 2021 and 2023 (n = 40, 58.8%). Most articles that evaluated pain and opioid use suggested that ESPB performed better than nonblocked groups (n = 26, 38.2% of total articles and n = 4, 5.88% of total articles) and performed similarly to other blocks. However, articles that evaluated the pectoral nerve block suggested it outperformed ESPB in these aspects (n = 6 articles, 8.82%). ESPB was shown to be a safe and procedurally short block to perform, effective in the hands of novice providers.
ESPB offers reliable outcomes, improving pain control and decreasing opioid consumption. In turn, this can decrease healthcare costs and patient morbidity.
在整形外科中，乳房手术患者是术后疼痛最易感受的群体之一。在阿片类药物泛滥的情况下，医疗目标旨在通过纳入区域镇痛来优化非阿片类多模式疼痛控制。竖脊肌平面阻滞（ESPB）是乳房手术中使用的几种区域阻滞方法之一。尽管椎旁阻滞以前一直是金标准，但专注于ESPB的新研究可能会改变标准。
2023年9月对PubMed进行了全面综述，以确定与ESPB在乳房手术中的应用相关的文章。排除非英文和无法获取的文章。提取的数据包括发表年份、技术和结果。
纳入了68篇出版物，其中31篇为随机对照试验（45.6%）。大多数发表于2021年至2023年之间（n = 40，58.8%）。大多数评估疼痛和阿片类药物使用的文章表明，ESPB的效果优于未阻滞组（n = 26，占文章总数的38.2%；n = 4，占文章总数的5.88%），并且与其他阻滞方法效果相似。然而，评估胸段神经阻滞的文章表明，在这些方面它优于ESPB（n = 6篇文章，8.82%）。ESPB被证明是一种安全且操作时间短的阻滞方法，新手医生也能有效操作。
ESPB能提供可靠的结果，改善疼痛控制并减少阿片类药物的使用。相应地，这可以降低医疗成本和患者发病率。
