Abstract
Objective To investigate the effects of ultrasound-guided single erector spinae plane (ESP) block on postoperative analgesia in patients with modified radical mastectomy. Methods Fifty patients who were going to receive modified radical mastectomy were enrolled and divided into patient controlled intravenous analgesia (PCIA) group and ESP block combined with PCIA group (EP group) according to the random number table method, with 25 cases in each group. ESP block was performed at patients in EP group under ultrasound guidance and local anesthesia; after 20 min, the blocking range was determined. Total intravenous anesthesia was implemented for anesthesia maintenance, target controlled infusion of propofol and remifentanil were conduced, and bispectral index value was maintained at 40-50. Patient controlled intravenous analgesia was performed after operation. Visual analogue scale (VAS) scores at rest and coughing were recorded at 30 min after extubation and 2, 6, 12, 24, 48 h after operation. The consumption of intraoperative remifentanil, the frequency of PCIA invalid pressing, the total number of PCIA pressing, requirements of flurbiprofen axetil in 48 h after surgery and adverse reactions were also recorded. Results In EP group with sensory loss came into effect from the second thoracic vertebra to the seventh thoracic vertebra or from the third thoracic vertebra to the eighth thoracic vertebra spinal nerve area 20 min after ESP block, and there was no puncture-related complication. The VAS scores at rest and coughing in EP group were lower than those in PCIA group during 30 min to 48 h after operation (P 0.05). Conclusions Ultrasound-guided single ESP block combined with PCIA is a safe and more effective method for modified radical mastectomy than PCIA only. Ultrasound-guided ESP block can provide good analgesia effect for modified radical mastectomy. Key words: Ultrasound-guided; Erector spinae plane block; Radical mastectomy; Postoperative pain
Published Version
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