Indian journal of anaesthesia · 2026
Comparison of costotransverse block and erector spinae plane block for perioperative analgesia in patients scheduled for modified radical mastectomy - A pilot study.
СтатьяНазвание и аннотация: Перевод в очереди
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Bharuka Aanchal R, Nayak Dhanya G, Naik Vibhavari Milind, Rayani Basanth K
Аннотация
BACKGROUND AND AIMS: Fascial plane blocks have emerged as a promising element for multimodal analgesia in breast surgeries. This study aimed to compare intra-operative and post-operative opioid requirements following costotransverse block (CTB) and erector spinae plane block (ESPB) for perioperative analgesia in patients scheduled for modified radical mastectomy (MRM).
METHODS: Sixty patients aged 25 to 65 years scheduled for MRM were randomised to receive either CTB or ESPB with 25 ml of 0.5% bupivacaine. The primary outcome was to compare the effectiveness of these two blocks in reducing the consumption of opioids for post-operative pain relief, measured by 24-hour morphine requirement. Secondary outcomes included time required to perform the block, intra-operative haemodynamics, total intra-operative fentanyl requirement, post-operative nausea and vomiting (PONV), and any complications related to the blocks.
RESULTS: The numeric rating scale scores were comparable between the groups at all time points during the 24-hour post-operative period. The rescue analgesic requirement (morphine), median (interquartile range) was similar in the CTB group (3 [3, 3] mg) and in the ESPB group (3 [3, 3.75] mg) (P = 1.00). The intra-operative fentanyl requirement median (interquartile range) was significantly higher in the ESPB group, 100 (100, 150) μg, than in the CTB group, 100 (100, 100) μg (P = 0.006). Incidence of PONV was comparable between the groups.
CONCLUSION: Both CTB and ESPB are comparable in providing post-operative analgesia for MRM patients. However, CTB likely offers better intra-operative analgesia as observed by the lower intra-operative opioid requirement.
METHODS: Sixty patients aged 25 to 65 years scheduled for MRM were randomised to receive either CTB or ESPB with 25 ml of 0.5% bupivacaine. The primary outcome was to compare the effectiveness of these two blocks in reducing the consumption of opioids for post-operative pain relief, measured by 24-hour morphine requirement. Secondary outcomes included time required to perform the block, intra-operative haemodynamics, total intra-operative fentanyl requirement, post-operative nausea and vomiting (PONV), and any complications related to the blocks.
RESULTS: The numeric rating scale scores were comparable between the groups at all time points during the 24-hour post-operative period. The rescue analgesic requirement (morphine), median (interquartile range) was similar in the CTB group (3 [3, 3] mg) and in the ESPB group (3 [3, 3.75] mg) (P = 1.00). The intra-operative fentanyl requirement median (interquartile range) was significantly higher in the ESPB group, 100 (100, 150) μg, than in the CTB group, 100 (100, 100) μg (P = 0.006). Incidence of PONV was comparable between the groups.
CONCLUSION: Both CTB and ESPB are comparable in providing post-operative analgesia for MRM patients. However, CTB likely offers better intra-operative analgesia as observed by the lower intra-operative opioid requirement.