Pectoserratus plane block versus erector spinae plane block for postoperative opioid consumption and acute and chronic pain after breast cancer surgery: A randomized controlled trial |
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| Affiliation: | 1. Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA;2. Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA;1. Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 3325, Los Angeles, CA 90095, USA;2. Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021, USA;3. Department of Urology, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue Box 951738, Los Angeles, CA 90095, USA;1. Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;2. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;3. Technical University of Munich, School of Medicine, Institute of General Practice and Health Services Research, Munich, Germany;4. Technical University of Munich, School of Medicine, Institute for AI and Informatics in Medicine, Munich, Germany;5. Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA;6. Outcomes Research Consortium, Cleveland, OH, USA;1. New York-Presbyterian Hospital - Weill Cornell, Department of Anesthesiology, 525 E 68th St, New York, NY 10065, United States;2. Weill Cornell Medicine, Department of Anesthesiology, 525 E 68th St, New York, NY 10065, United States;1. Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea;2. Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Republic of Korea;1. Department of Anesthesiology, Shanghai Children''s Medical Center, School of Medicine, Shanghai Jiao Tong University, China;2. Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, China |
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| Abstract: | Study objectiveBreast cancer is quite common in women, and surgery is the most effective treatment in most cases. This study compared the effects of ultrasound (US)-guided erector spinae plane block (ESPB) and pectoserratus plane block (PSPB) on the postoperative opioid consumption and acute and chronic pain in patients after breast cancer surgery.DesignProspective, randomized, single-blind.SettingUniversity hospital.PatientsThis study included 90 patients (ASA I-II) who underwent segmental mastectomy and sentinel lymph node biopsy at the hospital of Ondokuz Mayis University, Samsun.InterventionsThe patients were divided into the ESPB group, PSPB group, and control group. Intraoperatively, all patients were administered intravenous tenoxicam (20 mg) and paracetamol (1 g) as part of multimodal analgesia. Intravenous morphine via patient-controlled analgesia was administered in all groups postoperatively.MeasurementsThe primary outcome was the total morphine consumption in the first 24 h after surgery. The secondary outcomes included visual analog scale pain scores of the arm at rest and at abduction in the first 24 h and at 3 months postoperatively, intraoperative remifentanil consumption, number of patients requesting rescue analgesia, incidence of nausea and vomiting, time to the first request for analgesia via patient-controlled analgesia.Main resultsPostoperative 24-h morphine consumption, visual analog scale scores at rest and at abduction, and intraoperative remifentanil consumption were lower in the ESPB and PSPB groups than in the control group. Time to the first request for analgesia via patient controlled analgesia was longer in the ESPB and PSPB groups than in the control group. In the PSPB group, none of the patients needed rescue analgesia.ConclusionsUS-guided ESPB and PSPB performed in patients who underwent breast cancer surgery showed similar and modest analgesic effects on the postoperative opioid consumption and acute and chronic pain scores. |
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