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  • Efficacy of ultrasound-guided erector spinae plane block on postoperative quality of recovery and analgesia after modified radical mastectomy: randomized controlled trial

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Original article
Efficacy of ultrasound-guided erector spinae plane block on postoperative quality of recovery and analgesia after modified radical mastectomy: randomized controlled trial
  1. Yusheng Yao1,2,
  2. Hao Li2,
  3. Qiaolan He3,
  4. Tingting Chen4,
  5. Yihang Wang3 and
  6. Xiaochun Zheng1,2
  1. 1 Shengli Clinical Medical College, Fujian Medical University, Fuzhou, China
  2. 2 Anesthesiology, Fujian Provincial Hospital, Fuzhou, China
  3. 3 Anesthesiology, Fujian Medical University, Fuzhou, China
  4. 4 Anesthesiology, Fujian University of Traditional Chinese Medicine, Fuzhou, China
  1. Correspondence to Dr Xiaochun Zheng, Shengli Clinical Medical College, Fujian Medical University, Fuzhou 350001, China; fjslmzk{at}163.com

Abstract

Background Erector spinae plane block (ESPB) is a novel regional anesthesia technique that is gaining popularity for postoperative pain management. This randomized controlled trial evaluated the effect of ESPB on quality of recovery (QoR) in patients undergoing modified radical mastectomy.

Methods Eighty-two female patients undergoing modified radical mastectomy were included. Patients were randomly assigned to receive preoperative ultrasound-guided ESPB with either 0.5% ropivacaine or saline. The primary outcome was QoR, assessed 24 hours postoperatively using the 15-item QoR questionnaire (QoR-15). Secondary outcomes included postoperative pain scores, postoperative cumulative opioid consumption, postanesthesia care unit (PACU) discharge time, postoperative nausea or vomiting and dizziness.

Results Global QoR-15 scores 24 hours postoperatively were significantly higher (indicating better quality) in the ESPB group (median 120, IQR 118–124) compared with the control group (median 110, IQR 108.3–112.8), with a median difference of 10 (95% CI 9 to 12, p<0.001). Compared with the control group, ESPB with ropivacaine reduced pain scores up to 8 hours after surgery, as well as reduced postoperative cumulative opioid consumption and PACU discharge time.

Conclusions A single preoperative injection of ESPB with ropivacaine may improve QoR postoperatively and acute postoperative analgesia in patients undergoing a modified radical mastectomy.

Trial registration number ChiCTR-1800019599.

  • truncal blocks
  • acute pain
  • interventional pain management
  • postoperative pain

https://doi.org/10.1136/rapm-2019-100983

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    Footnotes

    • YY and HL contributed equally.

    • Contributors YY: conceptualization, design, supervision, validation, formal analysis and writing of the original draft. HL: design, project administration, data curation and writing of the original draft. QH: project administration, data curation, writing of the review and editing. TC: project administration, data curation and formal analysis. YW: project administration, data curation. XZ: conceptualization, design, resources, supervision, validation, writing, review and editing. All authors read and gave final approval of the version to be published.

    • Funding This study was supported by Fujian Medical University Startup Fund for scientific research (grant number 2018QH1142), Fujian Joint Funds for the Innovation of Science and Technology (grant number 2017Y9066), Natural Science Foundation of Fujian Province (grant number 2018J01246), Fujian Medical Innovation Project (grant number 2019-CXB-6) and Fujian educational research projects (grant number JAT160234).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval Our institutional research ethics board approved the study protocol for this single-center, prospective, randomized, double-blind, placebo-controlled clinical trial.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request.