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EP040 Ultrasound guided sub-transverse interligamentary block vs erector spinae plane block for post-operative pain management in carcinoma breast patients undergoing modified radical mastectomy
  1. Amrita Rath
  1. Anesthesiology, Institute of Medical Sciences, BHU, Varanasi, India


Background and Aims Ultrasound-guided regional anaesthesia techniques are recent congeners in multimodal pain management, leading to the development of fascial plane blocks. With the advent of ultrasound, alternative paraspinal blocks have been explored which include the Erector spinae plane [ESP] block and Sub-transverse interfragmentary [STIL] block. We aimed to assess the effectiveness and safety of STIL block in comparison with ESP block in patients undergoing Modified Radical Mastectomy.

Methods After ethical committee clearance, 150 female patients undergoing Modified Radical Mastectomy between 18-65 years of age with ASA grade I & II with informed consent were selected. After induction of general anaesthesia patients were placed in a lateral position and using a high-frequency linear ultrasound probe, 20 mL of 0.25% Levobupivacaine was given each in Group 1( ESP block) and Group 2(STIL). Post-operative pain in the form of the Numerical Rating Scale [NRS] was assessed. Changes in hemodynamic parameters, the total dose of opioid requirement, total duration of analgesia, total time taken for procedure and the number of doses of rescue analgesia required were also recorded.

Results NRS scores and requirement of rescue analgesia were significantly low and duration of analgesia was significantly high in Group 2 patients. Variations in haemodynamics were significantly less in group 2. The time taken for performing the procedure was significantly less in group 1.

Conclusions STIL block provides longer-acting analgesia with better hemodynamic outcomes as compared to ESP block in patients undergoing MRM. STIL block is however technically more challenging than ESP block.

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