The erector spinae plane (ESP) block is a technique that helps alleviate acute pain. It involves injecting local anesthetic between the erector spinae muscle (ESM) and the vertebra's transverse process (TP). This technique can be guided by ultrasound or anatomical landmarks, and it can be performed while the patient is lying down, sitting or on their side.
Ultrasound guidance has established itself as the norm for regional anesthesia procedures, enabling live visualization of anatomical structures and enhancing the precision and safety of needle insertion. Conversely, the blind technique relies on anatomical landmarks and the ability to palpate to direct needle insertion. Although the blind technique might provide simplicity and efficiency, uncertainties persist concerning its precision and possible associated risks. As the popularity of the ESPB increases, a relevant query emerges: Should it be conducted with ultrasound guidance or through a non-guided technique? This study was designed to validate the efficacy and safety of a landmark-guided ESPB technique compared to an ultrasound-guided ESPB technique for analgesia in breast surgery. The hypothesis was that the ultrasound and anatomical landmark techniques for ESPB would provide equivalent analgesia. The study's primary objective was to compare the success rate of both techniques. The secondary objectives were to compare the dermatomal block spread, analgesic effectiveness, and technique-related complications.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
248
The ESPB is a truncal block guided by ultrasound, involving the injection of local anesthetic beneath the erector spinae muscle (ESM), positioned between the ESM and the transverse process (TP) of the vertebra.
The ESPB is a truncal block guided by anatomical landmarks, involving the injection of local anesthetic beneath the erector spinae muscle (ESM), positioned between the ESM and the transverse process (TP) of the vertebra.
faculty of medicine, Alexandria Unverisity
Alexandria, Egypt
To compare the success rate of both landmark-guided ESPB and ultrasound-guided ESPB techniques for analgesia in breast surgery
The primary outcome was the binary outcome: therapeutic success or failure of ESPB techniques in achieving cutaneous sensory block for breast surgery (from T1 to T6).
Time frame: 30 minutes after regional block procedure
To compare the dermatomal block spread in both groups
Assessment of the number of blocked cutaneous sensory dermatomes from T1 to T10.
Time frame: 30 minutes after regional block procedure.
To compare the analgesic effectiveness in both groups
Assessment of rest visual analog score (VAS) for surgical site pain (0 -10) 2.
Time frame: The first 24 hours postoperatively at 1, 3, 6, 12, and 24 hours.
To compare the technique-related complications in both groups
Assessment of occurrence of adverse effects.
Time frame: During the regional block procedure.
To compare the analgesic effectiveness in both groups
The time (minutes) to the first intravenous patient-controlled analgesia (IV-PCA) demand dose.
Time frame: The first 24 hours postoperatively.
To compare the analgesic effectiveness in both groups
Total fentanyl opioid consumption (microgram).
Time frame: intra- and 24 hours postoperatively
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.