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Metabolomic Profiling of Erector Spinae Plane Block for Breast Cancer Surgery
Ekin Guran1, Ozan Kaplan2, Serpil Savlı1
1Department of Anesthesiology and Reanimation, Ankara Oncology Training and Research Hospital, The University of Health Sciences, Ankara, TR 06100, USA.
Medicina (Kaunas, Lithuania)
|July 30, 2025
Summary
The erector spinae plane (ESP) block provided effective pain relief and reduced opioid use in breast cancer surgery. ESP block also modulated immune responses by lowering specific metabolites and stress markers like VEGF and cortisol.
Area of Science:
- Oncology
- Anesthesiology
- Immunology
- Metabolomics
Background:
- Surgical stress and analgesia in cancer surgery can influence immune responses and cancer progression.
- Metabolomic profiling offers insights into systemic metabolic and immunological changes during the perioperative period.
- The erector spinae plane (ESP) block is a regional analgesic technique with potential immunomodulatory effects.
Purpose of the Study:
- To investigate the impact of the ESP block on the metabolomic profile in breast cancer surgery.
- To assess the effects of ESP block on VEGF, cortisol, and CRP levels.
- To evaluate the analgesic efficacy and opioid-sparing effects of the ESP block.
Main Methods:
- Ninety breast cancer patients were randomized into three groups: morphine, ESP block, and control.
- Pain scores (NRS), opioid consumption, VEGF, cortisol, and CRP levels were measured at T0, T1, and T24.
- Metabolomic analysis was performed on blood samples to identify systemic metabolic changes.
Main Results:
- The ESP group exhibited the lowest pain scores in the initial 12 hours and reduced opioid consumption.
- ESP block resulted in lower VEGF and cortisol levels compared to the control group at 24 hours postoperatively.
- Metabolites related to bile acid biosynthesis, steroid hormone biosynthesis, amino acid, and glutathione metabolism were altered in the ESP group.
Conclusions:
- The ESP block provides effective analgesia and reduces opioid requirements in breast cancer surgery.
- ESP block appears to modulate immune responses by altering key metabolic pathways and reducing stress markers.
- ESP block is a viable analgesic strategy that may favorably impact immune modulation in the perioperative care of breast cancer patients.
