The Erector Spinae Plane Block with 20 or 30 mL of 0.25% Bupivicaine Provides Equivalent Postoperative Analgesia after Mastectomy: A Prospective Randomized Trial.

Objective: Analgesia management following breast surgery is a critical concern. The erector spinae plane block (ESPB) is a regional anaesthesia technique that is frequently used for analgesia after breast surgery. However, there is no consensus on the volume. Therefore, the aim of this study was to compare ESPB performed using 20 mL vs. 30 mL.

Methods: The study included 43 female patients with American Society of Anesthesiologist class I-II physical status. Participants were randomized into two groups: 20 mL ESPB and 30 mL ESPB. Ibuprofen (400 mg) 3x1 was ordered, and a fentanyl patient-controlled analgesia device was attached intravenously to the participants. If the pain score was ≥4, meperidine (0.5 mg kg^-1) was administered.

Results: Postoperative fentanyl use was similar between the groups. There was no difference in the amount of rescue analgesic use between the groups. The static and dynamic numerical rating scores were similar between the groups. No statistical difference was noted in terms of nausea, vomiting, or itching between the groups.

Conclusion: A similar analgesic effect is achieved by performing ESPB using 20 or 30 mL of local anaesthetic at the same concentration.