Evaluation of Postoperative Pain in Patients Undergoing Erector Spinae Plane Block in Breast Surgeries
Erector Spinal Plane Block in Breast Surgeries
Keywords:
Erector spinae plane block, mastectomy, postoperative pain, patient-controlled analgesia, opioid consumption, tramadolAbstract
Objective: Postoperative pain remains a significant issue in mastectomy patients, and in recent years, regional block techniques have been frequently used in treatment. In this study, we evaluated the analgesic efficacy of erector spinae plane block (ESPB) in patients undergoing breast surgery.
Methods: Our study was conducted retrospectively by scanning the data of 94 adult female patients with ASA I-II-III who underwent breast surgery from medical records. Patients were divided into two groups: control group (Group 1) and ESP block group (Group 2). Both groups received postoperative intravenous patient-controlled analgesia (IV-PCA) tramadol for 24 hours. The primary objective was to assess pain intensity and postoperative opioid requirement using the visual analog scale (VAS) score. Additionally, postoperative hemodynamic data, adverse effects, demand for bolus tramadol from PCA, number of bolus doses received, total tramadol dose given, need for additional analgesia, and patient satisfaction were evaluated.
Results: No difference was found in postoperative hemodynamic data. VAS scores at postoperative 1st, 2nd, and 4th hours were significantly higher in the control group compared to the ESP group (p=0.002, p<0.0001, p=0.005, respectively). Postoperative nausea and vomiting were observed in 9.1% of patients in Group 1 while none were observed in Group 2, and this difference was significant in Group 1 (X2=4.747, p=0.029). Additional analgesic requirement at 12 hours was observed in 20.5% of patients in Group 1 and 2% in Group 2, and the difference was significant (X2=8.385, p=0.004). There was no significant difference between the groups in terms of PCA data and patient satisfaction.
Conclusion: Although ESP block reduced VAS scores in the early postoperative hours, we did not detect any effect on total tramadol consumption.