A Clinical Study to Assess the Efficacy of Erector Spinae Plane Block for Postoperative Analgesia after Modified Radical Mastectomy in a Tertiary Health Care Centre

Abstract

BACKGROUND Interfascial blocks like erector spinae plane block (ESP block) are relatively easy to perform and have potentially low risk profile. This study wanted to assess the efficacy of ultrasound guided ESP block for postoperative analgesia after modified radical mastectomy (MRM) as compared to conventional technique of surgical wound infiltration with local anaesthetic. The primary objective of the study was to assess the duration of postoperative analgesia. METHODS After obtaining institutional ethics committee clearance, a total of 26 females posted for MRM were randomly allocated into Group A (control group) and Group B (block group). Patients in Group A received general anaesthesia and local infiltration with 20 ml of 0.25% bupivacaine towards the end of surgery whereas patients in Group B received ultrasound guided ESP block preoperatively with 10 ml of 2% lignocaine with adrenaline and 20 ml of 0.25% bupivacaine with 8mg dexamethasone followed by general anaesthesia. Difference between the two groups were analysed using Mann Whitney U test or independent t test. RESULTS Duration of postoperative analgesia was significantly prolonged in ESP block group (2594.62 ± 216.742 min in block group vs. 274.2 ± 33.3 min in control group). Rest and motion VAS scores were significantly lower in ESP block group compared to control group. Also, patient satisfaction score in ESP block group was higher than in control group. Perioperative requirement of opioids and NSAIDs were significantly lower in ESP block group compared to control group. CONCLUSIONS ESP block is an effective block for prolonged postoperative analgesia after MRM. KEY WORDS Postoperative Analgesia, Modified Radical Mastectomy, Erector Spinae Plane Block