The effects of ultrasound-guided erector spinae plane block on intraoperative analgesic usage in unilateral breast surgery

The Effects of Ultrasound-guided Erector Spinae Plane Block on Intraoperative Analgesic Usage in Unilateral Breast Surgery Objective: Breast cancer is a common cancer in women and frequently requires surgical intervention for treatment. In recent years, ultrasound has become advantageous for anesthesia and in this regard, erector spinae plane (ESP) block is frequently performed as a part of multimodal analgesia in breast surgery. In our study, we aimed to evaluate the effects of preoperative erector spinae plane block on patients' narcotic analgesic usage during and after the operation. Materials and Methods: Our study consisted of 68 female patients schuduled unilateral breast surgery. The patients were divided into two groups; Group I (n=34) included 34 patients who received ESP block before surgery, while Group II was the control group that did not receive ESP block (n=34). Both groups received total intravenous anesthesia through propofol and remifentanil infusion. Follow the operation, all patients were supplied patient-controlled analgesia machines with morphine. The patients' satisfaction and pain levels were assessed using a patient satisfaction scale and visual analogue scale (VAS) for pain; the evaluations were performed on minutes 15, 30 and hours 1, 2, 4, 6, 8, 16, 24. The total amount of narcotics and additional analgesics used by the patients were recorded. Results: The ESP block group demonstrated a lower remifentanil usage during the operation; however, this was not statistically significant (p>0.05). At the end of the 24th hour following surgery; patients who received an ESP block showed lower VAS scores, reduced morphine usage, and higher patient satisfaction scores; these findings were statistically significant (p<0.05). Conclusion: ESP block is a contemporary peripheral nerve block associated with reduced complications and side effects. For this reason, we believe that it can be safely used as a part of multimodal analgesia in the postoperative pain management of frequently conducted breast surgeries. Keywords: Breast surgery, Erector Spinae Plane Block, Remifentanil, Morphine, Patient Satisfaction