Comparison of Efficacy of Ultrasound Guided Erector Spinae Block vs Paravertebral Block for Postoperative Analgesia in Breast Surgeries
Background: Effective management of postoperative pain (PSP) following breast surgeries is essential to improving recovery and preventing chronic pain syndromes. While the thoracic paravertebral block (TPVB) is the established standard for analgesia in breast surgeries, the erector spinae plane bloc...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-06-01
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| Series: | Journal of Pharmacy and Bioallied Sciences |
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| Online Access: | https://journals.lww.com/10.4103/jpbs.jpbs_1744_24 |
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| author | B Arun Kumar T Divyalakshmi R Brindha Naveena Pandian Panneerselvam Periasamy |
| author_facet | B Arun Kumar T Divyalakshmi R Brindha Naveena Pandian Panneerselvam Periasamy |
| author_sort | B Arun Kumar |
| collection | DOAJ |
| description | Background:
Effective management of postoperative pain (PSP) following breast surgeries is essential to improving recovery and preventing chronic pain syndromes. While the thoracic paravertebral block (TPVB) is the established standard for analgesia in breast surgeries, the erector spinae plane block (ESPB) has recently emerged as a simpler and safer alternative.
Aim:
To compare the efficacy of ultrasound-guided erector spinae block (ESPB) versus paravertebral block (TPVB) for postoperative analgesia in breast surgeries.
Methods:
A prospective randomized study was conducted on 60 patients undergoing elective breast surgeries at Vinayaka Missions Kirupananda Variyar Medical College and Hospitals, Salem. Patients were randomized into two groups: Group A (ESPB, 0.125% ropivacaine + dexmedetomidine) and Group B (TPVB, 0.125% ropivacaine + dexmedetomidine). Pain was assessed using the Visual Analog Scale (VAS) over 24 hours post-surgery. Secondary outcomes included hemodynamic stability, duration of sensory blockade, rescue analgesic requirements, and complications. Data were analyzed using EPI 2010 software.
Results:
Baseline hemodynamic parameters were comparable between the groups, except for higher systolic blood pressure (142.1 ± 3.8 mmHg vs. 136.5 ± 7.8 mmHg, P < 0.001) and VAS scores (4.5 ± 0.9 vs. 3.5 ± 0.8, P < 0.001) in Group B. Postoperatively, VAS scores were significantly lower in Group A from the 4-hour mark onwards (P < 0.006), indicating superior analgesic efficacy. Hemodynamic parameters, including heart rate and diastolic blood pressure, remained stable and comparable between the groups. No significant complications were observed in either group.
Conclusion:
Ultrasound-guided ESPB provides superior postoperative analgesia compared to TPVB, with consistent pain relief and similar hemodynamic stability. Its simplicity and safety profile make ESPB a promising alternative for pain management in breast surgeries. Further studies are warranted to validate these findings and optimize analgesic protocols. |
| format | Article |
| id | doaj-art-9d8cc836cab048e786a2e8bbce71e5c7 |
| institution | DOAJ |
| issn | 0976-4879 0975-7406 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Pharmacy and Bioallied Sciences |
| spelling | doaj-art-9d8cc836cab048e786a2e8bbce71e5c72025-08-20T03:15:20ZengWolters Kluwer Medknow PublicationsJournal of Pharmacy and Bioallied Sciences0976-48790975-74062025-06-0117Suppl 2S1927S192910.4103/jpbs.jpbs_1744_24Comparison of Efficacy of Ultrasound Guided Erector Spinae Block vs Paravertebral Block for Postoperative Analgesia in Breast SurgeriesB Arun KumarT DivyalakshmiR BrindhaNaveena PandianPanneerselvam PeriasamyBackground: Effective management of postoperative pain (PSP) following breast surgeries is essential to improving recovery and preventing chronic pain syndromes. While the thoracic paravertebral block (TPVB) is the established standard for analgesia in breast surgeries, the erector spinae plane block (ESPB) has recently emerged as a simpler and safer alternative. Aim: To compare the efficacy of ultrasound-guided erector spinae block (ESPB) versus paravertebral block (TPVB) for postoperative analgesia in breast surgeries. Methods: A prospective randomized study was conducted on 60 patients undergoing elective breast surgeries at Vinayaka Missions Kirupananda Variyar Medical College and Hospitals, Salem. Patients were randomized into two groups: Group A (ESPB, 0.125% ropivacaine + dexmedetomidine) and Group B (TPVB, 0.125% ropivacaine + dexmedetomidine). Pain was assessed using the Visual Analog Scale (VAS) over 24 hours post-surgery. Secondary outcomes included hemodynamic stability, duration of sensory blockade, rescue analgesic requirements, and complications. Data were analyzed using EPI 2010 software. Results: Baseline hemodynamic parameters were comparable between the groups, except for higher systolic blood pressure (142.1 ± 3.8 mmHg vs. 136.5 ± 7.8 mmHg, P < 0.001) and VAS scores (4.5 ± 0.9 vs. 3.5 ± 0.8, P < 0.001) in Group B. Postoperatively, VAS scores were significantly lower in Group A from the 4-hour mark onwards (P < 0.006), indicating superior analgesic efficacy. Hemodynamic parameters, including heart rate and diastolic blood pressure, remained stable and comparable between the groups. No significant complications were observed in either group. Conclusion: Ultrasound-guided ESPB provides superior postoperative analgesia compared to TPVB, with consistent pain relief and similar hemodynamic stability. Its simplicity and safety profile make ESPB a promising alternative for pain management in breast surgeries. Further studies are warranted to validate these findings and optimize analgesic protocols.https://journals.lww.com/10.4103/jpbs.jpbs_1744_24breast surgeryerector spinae plane blockparavertebral blockpostoperative analgesiaregional anesthesiavas score |
| spellingShingle | B Arun Kumar T Divyalakshmi R Brindha Naveena Pandian Panneerselvam Periasamy Comparison of Efficacy of Ultrasound Guided Erector Spinae Block vs Paravertebral Block for Postoperative Analgesia in Breast Surgeries Journal of Pharmacy and Bioallied Sciences breast surgery erector spinae plane block paravertebral block postoperative analgesia regional anesthesia vas score |
| title | Comparison of Efficacy of Ultrasound Guided Erector Spinae Block vs Paravertebral Block for Postoperative Analgesia in Breast Surgeries |
| title_full | Comparison of Efficacy of Ultrasound Guided Erector Spinae Block vs Paravertebral Block for Postoperative Analgesia in Breast Surgeries |
| title_fullStr | Comparison of Efficacy of Ultrasound Guided Erector Spinae Block vs Paravertebral Block for Postoperative Analgesia in Breast Surgeries |
| title_full_unstemmed | Comparison of Efficacy of Ultrasound Guided Erector Spinae Block vs Paravertebral Block for Postoperative Analgesia in Breast Surgeries |
| title_short | Comparison of Efficacy of Ultrasound Guided Erector Spinae Block vs Paravertebral Block for Postoperative Analgesia in Breast Surgeries |
| title_sort | comparison of efficacy of ultrasound guided erector spinae block vs paravertebral block for postoperative analgesia in breast surgeries |
| topic | breast surgery erector spinae plane block paravertebral block postoperative analgesia regional anesthesia vas score |
| url | https://journals.lww.com/10.4103/jpbs.jpbs_1744_24 |
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