Ultrasound guided erector spinae plane block for postoperative analgesia after augmentation mammoplasty: case series

Altıparmak, Başak; Toker, Melike Korkmaz; Uysal, Ali İhsan; Demirbilek, Semra

doi:10.1016/j.bjane.2018.12.008

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…Tilidine/naloxone 50/4 mg slow-release tablets have the same potency as tramadol but a lower incidence of abuse or dependency [ 52 ]. However, our results compare well with the average tramadol consumption of 70.8 ± 15.3 mg in the first 24 h after breast augmentation in 6 patients with postoperative ultrasound-guided erector spinae plane block [ 53 ].…”

Section: Discussionsupporting

confidence: 78%

Enhanced Recovery After Aesthetic Breast Surgery Under Sedation, Intercostal Block and Tumescent Anaesthesia: A Prospective Cohort Study of the Early Postoperative Phase

Stahl¹,

Stahl²,

Feng

et al. 2022

Aesth Plast Surg

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Background Comfort and recovery are major concerns of patients seeking aesthetic surgery. This study aimed to assess postoperative pain and recovery after outpatient breast surgery under sedation, intercostal block, and local anaesthesia. Methods This prospective cohort study included all consecutive patients who underwent aesthetic breast surgery between April 2021 and August 2022. Epidemiological data, anaesthesia, pain, and patients’ satisfaction were systematically assessed with standardized self-assessment questionnaires. Results Altogether, 48 patients [median (IQR) age: 30 (36–25)] were included. The most frequent surgery was mastopexy. 69% of surgeries involved additional procedures. The mean intercostal block and local anaesthesia time was 15 min. Patients received a median (IQR) of 19 (34–2) mg/kg lidocaine and 2.3 (2.5–2.0) mg/kg ropivacaine. The median (IQR) consumption of propofol and alfentanil was, respectively, 4.89 (5.48–4.26) mg/kg/h and 0.27 (0.39–0.19) µg/kg/min. No conversion to general anaesthesia or unplanned hospital admission occurred. Patients were discharged after a median (IQR) of 2:40 (3:43–1:58) hours. Within the first 24 postoperative hours, 17% required once an antiemetic medication and 38% an opioid. Patients were very satisfied with the anaesthesia and 90% of the patients had not wished more analgesia in the first 24 h. Conclusions Aesthetic breast surgery under sedation, intercostal block, and tumescent anaesthesia can safely be performed as an ambulatory procedure and is associated with minimal intra- and postoperative opioid consumption and high patient satisfaction. These data may be used to inform patients and clinicians and improve the overall quality of care. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . Supplementary Information The online version contains supplementary material available at 10.1007/s00266-022-03214-w.

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Section: Discussionsupporting

confidence: 78%

Enhanced Recovery After Aesthetic Breast Surgery Under Sedation, Intercostal Block and Tumescent Anaesthesia: A Prospective Cohort Study of the Early Postoperative Phase

Stahl¹,

Stahl²,

Feng

et al. 2022

Aesth Plast Surg

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Erector Spinae Plane Block Decreases Pain and Opioid Consumption in Breast Surgery: Systematic Review

ElHawary

Abdelhamid

Meng

et al. 2019

Plastic and Reconstructive Surgery - Global Open

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Background: Adequate control of acute postoperative pain is crucial in breast surgeries, as it is a significant factor in the development of persistent chronic pain. Inadequate postoperative pain control increases length of hospital stays and risk of severe complications. Erector spinae plane block (ESPB) is a novel regional block that has the ability to sufficiently block unilateral multidermatomal sensation from T1 to L3. By reviewing the literature on ESPB, this paper aimed to elucidate its efficacy in breast surgery analgesia and its role in addressing the opioid crisis in North America. Methods: PUBMED, EMBASE, and Cochrane databases were systematically searched for relevant articles according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Inclusion criteria included any articles that described ESPB in breast surgery. Exclusion criteria composed of articles that exclusively discussed other kinds of regional blocks. Results: Thirty-two articles including 6 randomized controlled trials were included in this review. ESPB demonstrated superior pain control and less opioid consumption compared with tumescent anesthesia or using no block. However, ESPB showed lower efficacy in pain control compared with pectoral nerve block. Patients experienced less nausea and vomiting and were overall more satisfied with ESPB compared with other pain control modalities. The vast majority of the studies reported the ease of ESPB administration, and only 1 case presented with a complication. Conclusions: ESPB is a promising form of regional anesthesia that can decrease postoperative pain and opioid consumption when used as part of multimodal pain analgesia for patients undergoing breast surgery.

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Ultrasound guided erector spinae plane block for postoperative analgesia after augmentation mammoplasty: case series

Cited by 2 publications

References 12 publications

Enhanced Recovery After Aesthetic Breast Surgery Under Sedation, Intercostal Block and Tumescent Anaesthesia: A Prospective Cohort Study of the Early Postoperative Phase

Enhanced Recovery After Aesthetic Breast Surgery Under Sedation, Intercostal Block and Tumescent Anaesthesia: A Prospective Cohort Study of the Early Postoperative Phase

Erector Spinae Plane Block Decreases Pain and Opioid Consumption in Breast Surgery: Systematic Review

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