Clinical effect of erector spinal plane block combined with opiate-free general anesthesia in breast cancer surgery

Objective To observe clinical effect of erector spinae plane block (ESPB) combined with opioid-free general anesthesia in patients undergoing breast cancer surgery.

Methods A total of 60 female patients aged 20 to 65 years and American Society of Association (ASA) type of class Ⅰ to Ⅱ undergoing unilateral breast cancer surgery were selected as study objects, and were randomly divided into group E(ESPB combined with opioid-free general anesthesia) and group C (opioid-free general anesthesia), with 30 cases in each group. The mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia induction (T₀), after anesthesia induction (T₁), after laryngeal mask implantation (T₂), after skin incision (T₃), 1 h after operation (T₄) and at the end of surgery (T₅). Visual analogue scale (VAS) scores at rest and activity and analgesia within 48 h after surgery were recorded at PACU, postoperative 2 h, 6 h, 12 h, 24 h and 48 h. Postoperative extubation time, PACU residence time, first anal exhaust and ambulation time, and the occurrence of adverse reactions within 48 h after surgery were observed and recorded in two groups.

Results Compared with T₀, MAP and HR were all lower at T₁ to T₄ in group C (P < 0.05). Compared withT₀, MAP at T₁ to T₄ and HR at T₁ to T₅ in group E were decreased, and the differences were statistically significant (P < 0.05). Compared with group C, group E had a higher MAP at T₁ and a lower HR at T₄, and the difference was statistically significant (P < 0.05). There were 12 (41.4%) and 4 (14.3%) cases of intraoperative hypotension in group C and group E, respectively. The proportion of hypotension in the group E was lower than that in group C (P < 0.05). Compared group C, the VAS scores entering PACU and within postoperative 2 h were lower, and VAS score at activity entering PACU was lower(P < 0.05). PACU residence time and first anal exhaust time in the group E were shorter than those in group C (P < 0.05). No obvious bradycardia was observed in the two groups within 48 h after operation. The incidence of total adverse reactions in the group E within 48 h after surgery was lower than that in group C, especially the incidence of postoperative nausea and vomiting, the difference was statistically significant (P < 0.05).

Conclusion ESPB combined with opioid-free general anesthesia has satisfactory clinical efficacy and less complication, which is beneficial for Rapid postoperative recovery.