Analgesic efficacy of ultrasound-guided erector spinae block and pectoral nerve block in patients undergoing modified radical mastectomy: A randomized control trial

Abstract

Background and Aims: Modified radical mastectomy (MRM) is the commonest surgical procedure performed for carcinoma breasts. MRM is associated with considerable postoperative pain. This study was aimed to compare the analgesic efficacy of erector spinae plane (ESP) block and pectoral nerve (PECS) block. Materials and Methods: A total 70 female patients, American Society of Anesthesiologist Physical Status I-II, aged between 18 and 65 years, undergoing MRM surgery. Patients were randomly divided into two equal groups of 35 each, by computer-generated random number table. Group E patients, received ESP block with 20 mL of 0.25% levobupivacaine, and Group P patients, received PECS block with 30 mL of 0.25% of levobupivacaine. The surgical procedure was conducted under general anesthesia in both groups. The primary objective was total morphine consumption in the first 24 h and secondary objectives were intraoperative fentanyl needed, duration of analgesia, numeric rating scale (NRS) score, postoperative complications, and patient's satisfaction. The Statistical Package for the Social Science (SPSS) software version 22.0 used for statistical analysis. Results: Demographic data, hemodynamic parameters, and intraoperative fentanyl consumption were comparable between the two groups (P > 0.05). Postoperative morphine consumed in the first 24 h was less in the Group P compared to Group E (P = 0.018). The duration of analgesia was significantly prolonged in the Group P than Group E (P < 0.0001). The NRS score, postoperative complications, and patient's satisfaction were comparable. Conclusion: The PECS block is more effective analgesic modality compared to ESP blocks in patients undergoing MRM surgeries.