Opioid-free mastectomy in combination with ultrasound-guided erector spinae block: A series of five cases

Ultrasound guided Erector Spinae Plane block versus thoracic epidural for post-mastectomy analgesia

“…Similarly, Gürkan and coworkers 19 in a randomized control trial on the analgesic effect of US-guided single shot ESP for breast surgery observed a statistically significant decrease in postoperative morphine consumption, establishing its role for analgesia and postoperative opioid-sparing effect. Nair et al 20 reported efficacy of this block in a case series of 5 patients subjected to thoracic surgery. Also, previous authors stated in their case reports that both visceral and somatic pain were efficiently abolished by the use of ESP block 21,22 .…”

The risks associated with erector spinae plane block in patients with abnormalities of coagulation

“…However, that depends on the level at which the block is performed. This sparing can be addressed by using a high-volume of local anesthetic for the block (up to 30 ml) [3].…”

Regional block: Walking away from central to peripheral nerves and planes for local anaesthetic drug deposition

“…This journal has published in the past various original articles and reports pertaining to these newer blocks and their comparisons with older blocks. [234567891011121314] This issue of the journal reports a randomised trial wherein COMBIPECS (combinations of Pecs 1 and Pecs 2) block has been studied for breast surgeries. [15]…”

“…Most of the studies related to fascial plane block are primarily related to the analgesic effect as the primary outcome measure. [2456789101112131415] The majority of the studies report that addition of these newer blocks decreases the requirement of analgesics (specifically opioid) during the perioperative period. The comparative study among individual blocks has reported variable results and the superiority of an individual block has not been determined conclusively.…”

“…Injection of drug in fascial plane may lead to adhesion and may interfere with surgical interventions in future. The newer fascial plane blocks have been reported primarily for analgesia[2456789101112131415] and not as sole anaesthetics. [3] The role of these blocks alone or in combination for effective anaesthesia needs further exploration.…”