Comparison of Ultrasound-guided Erector Spinae Plane Block Versus Rhomboid Intercostal Block for Perioperative...

Over 75% of women who have post-mastectomy reconstruction feel significant pain right away, and about 50% endure chronic pain. Thus, increasing the efficiency of postoperative pain management is crucial. Our study investigated the effects of ultrasound-guided erector spinae plane blocks (ESPB) and rhomboid intercostal blocks (RIB) on perioperative fentanyl use and pain scores in patients undergoing radical mastectomy surgery.

This was a double-blind, randomised controlled trial conducted at a tertiary care hospital. Patients with breast cancer aged 18-70 years and American Society of Anaesthesiologists status I-II who were scheduled for unilateral modified radical mastectomy were included. They were randomly assigned to two groups. ESPB was performed in the ESPB group, and RIB was performed in the RIB group, using ultrasound guidance. Total postoperative fentanyl usage in the first 24 hours was the primary outcome indicator of the study. Intraoperative fentanyl requirements and numerical rating scale (NRS) scores at seven distinct time points were used as secondary outcome measures.

The difference between the mean of total postoperative fentanyl consumption in 24 hours in Group ESPB (2.67±0.68 μg kg^-1) and Group RIB (3.68±1.22 μg kg^-1) was statistically significant (t value: -4.183, df:66, P value: < 0.001). There was no difference in intraoperative opioid consumption between the groups (P=0.7). However, NRS scores were not significantly different between the ESPB group and the RIB group.

Our study's outcome demonstrates ultrasound-guided ESPB to be more effective than RIB in terms of lower perioperative fentanyl consumption.