scholarly journals Erector spinae plane block OR modified pectoralis block for postoperative analgesia after modified radical mastectomy: Which is better ???

2020 ◽  
Vol 7 (3) ◽  
pp. 496-501
Author(s):  
Anshit Abhi Pathania ◽  
◽  
Shweta Mahajan ◽  
Rita Khanoria ◽  
◽  
...  
Author(s):  
Martina Farag Wahba Mekhaeil ◽  
Ayman Abd Elmaksod Yousef ◽  
Hesham Mohammed Marof ◽  
Shaimaa Farouk Abdelkader

Background: Breast Cancer is the most commonly occurring cancer affecting ‎women undergoing modified radical mastectomy, causing acute pain, and in ‎high percentage of patients it progresses to chronic pain syndromes. The Erector Spinae Plane Block (ESPB) ‎and Serratus Anterior Plane Block (SAPB) are options of regional anesthesia that can produce reliable ‎analgesia. In this study we aimed to evaluate the analgesic efficacy of ‎ultrasound guided ESPB and SAPB in patients underwent modified radical ‎mastectomy operation. Patients and Methods: Patients were randomly classified using computer generated numbers ‎concealed in ‎ sealed opaque envelopes into three equal groups; 30 patients ‎were enrolled in each group. ‎Group I: Control Group (C): Patients received intravenous (IV) systemic analgesia only, Group II: ESPB group: Patients received ‎ipsilateral ultrasound guided ESPB using 20 ml bupivacaine 0.25% at the ‎level of the 4th thoracic segment (T4). and Group III: SPB group: Patients received ipsilateral ‎serratus plane block using 30 ml bupivacaine 0.25% at the level of the 5th rib.‎ Results: In this study, 113 patients were assessed for eligibility, 16 patients ‎did not meet the criteria and 7 patients refused to participate in the study. ‎The remaining 90 patients were randomly allocated into three groups (30 ‎patients in each). All patients (90) were followed-up and analyzed ‎statistically‎. Conclusion: Ultrasound-guided SAPB and ESPB provided effective post-‎operative analgesia in patients undergoing modified radical mastectomy with ‎lower pain scores, less peri operative analgesic consumption and longer ‎duration of analgesia in SAPB.


2021 ◽  
Vol 8 (6) ◽  
pp. 1854
Author(s):  
Sumit Kumar Gupta ◽  
Arpit Garg ◽  
Sirisha Anne ◽  
Ajit Bhardwaj

Background: The number of breast cancer surgeries in India are increasing in the recent years. Lifestyle changes and increased awareness are the two important factors contributing to the same. Newer methods of anaesthetic management are also being practised for overall benefit of the patient. Recent advances in the regional anaesthesia techniques especially under the guidance of ultrasonography, dramatically changed not only the operative outcomes but also the post-operative stay in the hospital. The present study was aimed to bring out differences between two popular options of opioid sparing regional anaesthesia techniques for post-operative analgesia for patients who had undergone modified radical mastectomy (MRM) for carcinoma breast at our centre.Methods: A total of 88 patients of ASA II and III grading were enrolled in the study who had received either of erector spinae plane block (ESB) or thoracic paravertebral block (TPVB). Post-op numerical rating scale for pain and analgesic requirements were compared between the two groups. Hemodynamic parameters were recorded for comparing the influence of the blocks on hemodynamics.Results: The demographic profile was similar between the 2 groups. The study showed that TPVB have a higher efficacy of analgesia when compared with that of ESB. However, there is no significant differences in the intra-op and post-op hemodynamics.Conclusions: In view of a higher safety profile of ESB, administration of the same may still be preferred over the TPVB especially in those with less experienced hands in patients undergoing modified radical mastectomy.


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