Background & Aims
Introduction :
In Algeria, the incidence of breast cancer is increasing steadily. Currently, more than 14,000 cases are recorded each year. Surgery is the cornerstone in the treatment of breast cancer. The intensity of post-operative pain varies depending on the procedure; moderate in the case of lumpectomy to intense in the case of a mastectomy plus axillary dissection.
Management of postoperative pain has evolved in recent years towards multimodal analgesia with opioid sparing as described in our department. Several locoregional are practiced, Paravertebral Block (BPV), PECS and the Spinal Erector Block (ESP).
Objective :
Does the spinal erector block (ESP) have an impact in the management of chronic pain in oncological breast surgery?
Methods
Material and method :
This is a single-center prospective observational study carried out at the Army Central Hospital.
The inclusion period from 2020.
Patients benefit from an ESP block at level T4 with a single injection of 20 ml of Bupivacaine 0.25%.
The endpoint is the assessment of pain at 3 months, 6 months and 1 year using the DN4 Questionnaire
Results
Result :
These are 40 patients with an average age of 45+11.
The Spinal Erector Block (ESP) being easy to perform by novice residents, reduces the consumption of opioids.
Conclusions
Conclusion :
The spinal erector block (ESP) is a good alternative for analgesia after breast cancer surgery. It helps reduce acute postoperative pain with opioid sparing and appears to be effective for chronic pain. Further studies are needed to conclude this.
References
Ultrasound guided erector spinae plane block reduces postoperative opioid consumption following breast surgery: A randomized controlled study.
Gürkan Y, et al. J Clin Anesth. 2018. PMID: 29980005 Clinical Trial.
The effect of ultrasound-guided intercostal nerve block, single-injection erector spinae plane block and multiple-injection paravertebral block on postoperative analgesia in thoracoscopic surgery: A randomized, double-blinded, clinical trial.
Chen N, et al. J Clin Anesth. 2020. PMID: 31330457 Clinical Trial.
Comparison of the effects of modified pectoral nerve block and erector spinae plane block on postoperative opioid consumption and pain scores of patients after radical mastectomy surgery: A prospective, randomized, controlled trial.
Alt?parmak B, et al. J Clin Anesth. 2019. PMID: 30396100 Clinical Trial.
Presenting Author
Widad Kouachi
Poster Authors
Widad KOUACHI
Associate professor
Hca Algeria
Lead Author
Topics
- Models: Acute Pain