• Can Aksu, Alparslan Kuş, Hadi Ufuk Yörükoğlu, Cennet Tor Kılıç, and Yavuz Gürkan.
• Department of Anesthesiology and Reanimation, Kocaeli University, Kocaeli, Turkey.
• Agri. 2019 Jul 1; 31 (3): 132-137.

ObjectivesDue to the complex breast innervation, postoperative analgesia after breast surgery is a challenge for the anesthesiologists. The erector spinae plane block (ESPB) is a newly defined promising technique for this purpose. The main purpose of this study was to evaluate the analgesic efficacy of the ultrasound-guided ESPB in breast surgery, monitoring its effect on the postoperative opioid consumption.MethodsFifty female patients, who were scheduled to undergo elective breast surgery, with the American Society of Anesthesiology physical score I-II, and aged between 25 and 70 years, were included into the study. Patients were randomized into two groups, as the ESPB and the control group. All patients in the ESPB group received a bi-level (T2-T4) ultrasound-guided ESPB with 20 ml 0.25 % bupivacaine (10 ml for each level) preoperatively. An intravenous patient-controlled analgesia device for the postoperative analgesia was given to all patients. The numeric rating scale (NRS) scores for pain and postoperative morphine consumptions were recorded at the 1st, 6th, 12th, and 24th hour postoperatively.ResultsPostoperative morphine consumption was significantly lower in the ESPB group compared to the control group at the postoperative 6th, 12th, and 24th hour (p<0.001 for each time interval). The morphine consumption at the 24-hour was reduced by 75%. There was no significant difference in the NRS scores (median NRS values were 2, 1, 0, 0, and 2, 2, 1, 1, respectively).ConclusionOur study has shown that a significant opioid-sparing analgesic effect in patients undergoing breast surgery could be achieved with a US-guided bi-level ESP block.

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