TO STUDY THE LONG-TERM BENEFITS OF ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK ON POST-MASTECTOMY PAIN SYNDROME IN PATIENTS UNDERGOING BREAST SURGERY: A RCT BACKGROUND drnishkarshgupta@gmail.com

 

TO STUDY THE LONG-TERM BENEFITS OF ULTRASOUND-GUIDED ERECTOR SPINAE PLANE BLOCK ON POST-MASTECTOMY PAIN SYNDROME IN PATIENTS UNDERGOING BREAST SURGERY: A RCT BACKGROUND

4

 

 

 

 

India

Oral or Poster

Post-mastectomy pain syndrome(PMPS) is common(20% - 68%) and is characterized by neuropathic pain. Erector Spinae Plane(ESP) block is one interventional procedure that provides good perioperative analgesia. This study aimed to assess the effect of the ESP block on PMPS at 3 months.

After IEC approval and CTRI registration, 130 ASA I/II adult females undergoing elective unilateral breast surgery were randomized to receive USG-guided ESP block or standard pain management in addition to general anaesthesia. NRS score, hemodynamics, the need for opioids by PCA pump(CADD-Legacy®), and side effects such as PONV, pruritus, and sedation were noted. Patients were evaluated 3- months after surgery for PMPS.

The demographic characteristics (age, weight, height, BMI, ASA grade) were comparable (p>0.05). The incidence of PMPS (32.1%vs.45.8%;RR 0.71;95% CI:0.58–0.86;p < 0.01), median pain intensity [(1 [0, 1]) vs.(2 [1, 2]), p < 0.01] and median pain rating index [(0 [0, 2]) vs.(2 [1, 4]), p < 0.01] was lower with ESP at 3 months. ESP Block group had significantly lower median(IQR) total morphine consumption(4 mg,2–8 mg vs. 8 mg,4–10 mg;P < 0.01), lower doses of morphine boluses at all time points and lower pain scores at rest and during activity at all time points (Fig1). The ESP group shows significant improvements in Self-Care, Usual Activity, and Pain.

Preoperative ESP block reduces PMPS and improves quality of life at 3 months in patients undergoing mastectomy. It should be used more often to avail the long-term benefits of Regional anesthesia in patients undergoing surgery.