A Comparative Study between Superficial Erector Spinae Muscle Block versus Deep Erector Spinae Muscle Block for Assessment of Pain Control during Radical Mastectomy Procedures

Document Type : Original Article

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Department of Anesthesiology, Faculty of Medicine, Benha University, Qalyubiyya, Egypt

Abstract

Background and Aim of the work: The superficial erector spinae muscle block or deep erector spinae muscle block is an effective approach for analgesia in thoracic surgical and chest trauma, providing excellent pain relief while reducing narcotic requirements. Our study compares superficial erector spinae muscle block versus deep erector spinae muscle block for assessment of pain during radical mastectomy procedures.
Patients and Methods: The patients were randomized into two groups of 30 each. Group I received 20 mL of 0.25% bupivacaine superficial to erector spinae muscle at the T4 level, while those in Group II received 20 mL of 0.25% bupivacaine deep to erector spinae muscle at the T4 level.
Results: As regards VAS, there was a significant decline [P = 0.001] in the middle VAS in group II when distinguished from group I at 12 h and a statistically significant decline [P = 0.035] at 8 h postoperatively. Also, as regards the moment of truth of first rescue analgesic, skilled was a considerably longer in group II when compared with group I [p value= 0.005], and the total measurement of morphine devouring was considerably lower in group II [6 ± 2 mg/24 h] when distinguished from group I [9 ± 2 mg/24 h].
Conclusion: Superficial erector spinae muscle block may be used as a method for controlling pain after radical mastectomy, but deep erector spinae muscle block is more effective than it.

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