The quality of recovery after erector spinae plane block in patients undergoing breast surgery: a randomized controlled trial
Abstract Background The erector spinae plane (ESP) block has recently been shown to effectively alleviate postoperative pain and reduce opioid consumption in breast surgery patients. However, data are still limited concerning the quality of recovery in patients following this procedure. Methods This...
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Anesthesiology |
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| Online Access: | https://doi.org/10.1186/s12871-022-01760-z |
| _version_ | 1811294637167476736 |
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| author | Marcin Wiech Paweł Piwowarczyk Marcin Mieszkowski Bułat Tuyakov Karolina Pituch-Sala Tomasz Czarnik Andrzej Kurylcio Mirosław Czuczwar Michał Borys |
| author_facet | Marcin Wiech Paweł Piwowarczyk Marcin Mieszkowski Bułat Tuyakov Karolina Pituch-Sala Tomasz Czarnik Andrzej Kurylcio Mirosław Czuczwar Michał Borys |
| author_sort | Marcin Wiech |
| collection | DOAJ |
| description | Abstract Background The erector spinae plane (ESP) block has recently been shown to effectively alleviate postoperative pain and reduce opioid consumption in breast surgery patients. However, data are still limited concerning the quality of recovery in patients following this procedure. Methods This study was a randomized controlled trial (RCT) performed in a university hospital. We randomly allocated patients to one of three groups: ESP, SHAM, and control (CON). Procedures in the ESP and SHAM blocks were performed ipsilaterally with 0.375% ropivacaine or 0.9% saline (0.4 mL/kg). Our primary outcome was the assessment of the patient’s improvement with quality-of-recovery 40 (QoR-40) a day after surgery. Other outcome assessments included postoperative pain evaluation on the visual analog scale (VAS), 24-hour opioid consumption with patient-controlled analgesia (PCA), time to the first opioid demand, and global satisfaction with perioperative treatment. Results Overall, patients in the ESP group had improved QoR-40 compared to the CON group, 186 [177–193] vs. 175 [165–183] (medians and interquartile ranges). Pain severity was significantly higher in the CON group compared to the ESP group at hours 2 (38 [23–53] vs. 20 [7–32]) and 4 (30 [18–51] vs. 19 [7–25]). Moreover, we observed lower oxycodone consumption after 24 hours with the PCA pump between the ESP (4 [2–8] mg) and the CON (9.5 [5–19]) groups. Patients in the CON group used PCA sooner than those in the ESP group. Participants in the ESP group were more satisfied with treatment than those in the CON group. We found no statistical difference between SHAM and the other groups. Conclusions Compared to the CON group, the ESP block improved the quality of recovery, alleviated pain intensity, and lowered opioid consumption in patients undergoing breast surgery. However, we did not observe this superiority in comparison with the SHAM group. Trial registration NCT04726878 . |
| first_indexed | 2024-04-13T05:20:24Z |
| format | Article |
| id | doaj.art-9681673addec4ada94109218c0f04e86 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-04-13T05:20:24Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-9681673addec4ada94109218c0f04e862022-12-22T03:00:47ZengBMCBMC Anesthesiology1471-22532022-07-012211910.1186/s12871-022-01760-zThe quality of recovery after erector spinae plane block in patients undergoing breast surgery: a randomized controlled trialMarcin Wiech0Paweł Piwowarczyk1Marcin Mieszkowski2Bułat Tuyakov3Karolina Pituch-Sala4Tomasz Czarnik5Andrzej Kurylcio6Mirosław Czuczwar7Michał Borys8Second Department of Anesthesiology and Intensive Care Medicine, Medical University of LublinSecond Department of Anesthesiology and Intensive Care Medicine, Medical University of LublinDepartment of Anesthesiology and Intensive Care, Regional Specialist Teaching HospitalDepartment of Anesthesiology and Intensive Care, Regional Specialist Teaching HospitalSecond Department of Anesthesiology and Intensive Care Medicine, Medical University of LublinDepartment of Anesthesiology, Intensive Care and Regional ECMO Center, Institute of Medical Sciences, Opole UniversityDepartment of Surgical Oncology, Medical University of LublinSecond Department of Anesthesiology and Intensive Care Medicine, Medical University of LublinSecond Department of Anesthesiology and Intensive Care Medicine, Medical University of LublinAbstract Background The erector spinae plane (ESP) block has recently been shown to effectively alleviate postoperative pain and reduce opioid consumption in breast surgery patients. However, data are still limited concerning the quality of recovery in patients following this procedure. Methods This study was a randomized controlled trial (RCT) performed in a university hospital. We randomly allocated patients to one of three groups: ESP, SHAM, and control (CON). Procedures in the ESP and SHAM blocks were performed ipsilaterally with 0.375% ropivacaine or 0.9% saline (0.4 mL/kg). Our primary outcome was the assessment of the patient’s improvement with quality-of-recovery 40 (QoR-40) a day after surgery. Other outcome assessments included postoperative pain evaluation on the visual analog scale (VAS), 24-hour opioid consumption with patient-controlled analgesia (PCA), time to the first opioid demand, and global satisfaction with perioperative treatment. Results Overall, patients in the ESP group had improved QoR-40 compared to the CON group, 186 [177–193] vs. 175 [165–183] (medians and interquartile ranges). Pain severity was significantly higher in the CON group compared to the ESP group at hours 2 (38 [23–53] vs. 20 [7–32]) and 4 (30 [18–51] vs. 19 [7–25]). Moreover, we observed lower oxycodone consumption after 24 hours with the PCA pump between the ESP (4 [2–8] mg) and the CON (9.5 [5–19]) groups. Patients in the CON group used PCA sooner than those in the ESP group. Participants in the ESP group were more satisfied with treatment than those in the CON group. We found no statistical difference between SHAM and the other groups. Conclusions Compared to the CON group, the ESP block improved the quality of recovery, alleviated pain intensity, and lowered opioid consumption in patients undergoing breast surgery. However, we did not observe this superiority in comparison with the SHAM group. Trial registration NCT04726878 .https://doi.org/10.1186/s12871-022-01760-zErector spinae plane blockBreast surgeryQuality of recoveryVisual analog scalePatient-controlled analgesia |
| spellingShingle | Marcin Wiech Paweł Piwowarczyk Marcin Mieszkowski Bułat Tuyakov Karolina Pituch-Sala Tomasz Czarnik Andrzej Kurylcio Mirosław Czuczwar Michał Borys The quality of recovery after erector spinae plane block in patients undergoing breast surgery: a randomized controlled trial BMC Anesthesiology Erector spinae plane block Breast surgery Quality of recovery Visual analog scale Patient-controlled analgesia |
| title | The quality of recovery after erector spinae plane block in patients undergoing breast surgery: a randomized controlled trial |
| title_full | The quality of recovery after erector spinae plane block in patients undergoing breast surgery: a randomized controlled trial |
| title_fullStr | The quality of recovery after erector spinae plane block in patients undergoing breast surgery: a randomized controlled trial |
| title_full_unstemmed | The quality of recovery after erector spinae plane block in patients undergoing breast surgery: a randomized controlled trial |
| title_short | The quality of recovery after erector spinae plane block in patients undergoing breast surgery: a randomized controlled trial |
| title_sort | quality of recovery after erector spinae plane block in patients undergoing breast surgery a randomized controlled trial |
| topic | Erector spinae plane block Breast surgery Quality of recovery Visual analog scale Patient-controlled analgesia |
| url | https://doi.org/10.1186/s12871-022-01760-z |
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