Abstract No. : ABS1591: Effect of erector spinae block and PECS block on quality of recovery and analgesia after modified radical mastectomy

Abstract

Background and Aims:Breast cancer is the most common malignancy in women ; modified radical mastectomy is one of the standard treatments.This study compared the effect of erector spinae block and pectoralis(PECS) block on quality of recovery and analgesia after modified radical mastectomyMethods:The present randomised controlled double-blind study was conducted on 90 patients undergoing unilateral modified radical mastectomy for breast cancer. The patients were randomised into group-I (PECS block 20ml 0.25% bupivacaine, n=30), group-II (erector spinae block 20ml 0.25% bupivacaine, n=30) and group-III (control group, n=30). Along with clinical anddemographical data, the requirement of the first dose of rescue analgesia, total rescue analgesic consumption, visual analogue scale(VAS) scores and Quality of Recovery(QoR) -40 scoreswere compared. Anaesthesia and surgical interventions were done as per standard protocol.Results:Mean first rescue analgesic requirement was significantly delayed in group-I followed by group-II compared to controls . Mean total rescue analgesic consumption was much lower in group-I and group-II as compared to group-III and the difference was statistically significant (p<0.0001)(figure 1). Mean VAS scores were also much lower in group-I followed by group-II as compared to group-III at different follow-ups, and difference was statistically significant. The global QoR-40 at 24 hours showed significantly better outcomes in group-1(table 1)Figure 1Global QoR-40 between the groupsTable 1Postoperative tramadol requirementAnalgesic requirementGroup B (n=30)Group C (n=30) P Time for 1st need of tramadol (h)8.10±1.480.7±0.38<0.001Total tramadol consumption (mg)68±48.55210±52.65<0.0001Total numberof patients requiring tramadol (%) 24 h10 (33.33%)30 (100%)<0.0001Table 1Quality of Recovery(QoR) -40 scores between the groupsGlobal QoR-40 (0-200)Group I (n=30)Group-II (n=30)Group-III (n=30) P Pre-operative186.63±7.78185.53±6.73186.34±7.56P=0.8360At 24 h183.64±6.36179.68±6.38171.37±6.88P<0.001* P t=1.63, P=0.1086t=3.455, P=0.0010*t=8.021, P<0.001*Conclusion:Both PECS and ESP block can be used efficaciously for providing analgesia in modified radical mastectomy for breast cancer. However, PECS shows better outcomes.