Background@#We aimed to investigate the
analgesic efficacy of an erector spinae plane block (ESPB) in immediate
breast reconstruction (IBR) with a
tissue expander . @*
Methods @#
Adult women undergoing IBR with a
tissue expander after
mastectomy were randomly assigned to either intravenous
patient-controlled analgesia (IV-
PCA ) alone (group P) or IV-
PCA plus ESPB (group E). The primary outcome was the total amount of
opioid consumption during 24 hours postoperatively between the two groups.
Secondary outcomes were
patient satisfaction ,
pain score at
rest and on
shoulder movement using numerical rating scale,
incidences of
postoperative nausea and vomiting (
PONV ), and a short form of the brief
pain inventory (BPI-SF) at 3 and 6 months after
surgery between the groups. @*Results@#Fifty eight
patients completed the study. At 24 hours postoperatively, total
opioid consumption was significantly less in group E than in group P (285.0 ± 92.0, 95%
confidence interval [CI] 250.1 to 320.0 vs. 223.2 ± 83.4, 95% CI 191.5 to 254.9, P = 0.005). Intraoperative and cumulative
PCA fentanyl consumption at 3, 6, 9, and 24 hours were also less in group E than in group P (P = 0.004, P = 0.048, P = 0.020, P = 0.036, and P < 0.001, respectively).
Patient satisfaction was higher in group E (6.9 ± 1.8 vs. 7.8 ± 1.4, P = 0.042). The
incidences of
PONV was
similar . @*Conclusions@#The ESPB decreased postoperative
opioid consumption and increased
patient satisfaction without significant
complications after IBR with a
tissue expander after
mastectomy .