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Aesthetic Plastic Surgery

, Volume 43, Issue 2, pp 291–296 | Cite as

Ultrasound-Guided Bilateral Erector Spinae Block Versus Tumescent Anesthesia for Postoperative Analgesia in Patients Undergoing Reduction Mammoplasty: A Randomized Controlled Study

  • Gozen Oksuz
  • Fatma BilgenEmail author
  • Mahmut Arslan
  • Yakup Duman
  • Aykut Urfalıoglu
  • Bora Bilal
Original Article Breast Surgery

Abstract

Purpose

The aim of this prospective, randomized, double-blind study was to compare the tumescent anesthesia method and erector spinae block with respect to postoperative analgesia consumption, pain scores and patient satisfaction, in patients receiving breast reduction surgery under general anesthesia.

Methods

The study included 44 females, aged 20–65 years, who were to undergo breast reduction surgery, without adjunctive liposuction on the breast. Using the closed envelope method, the patients were randomly separated into two groups to receive tumescent anesthesia or erector spinae block (ESB). Patients in the ESB group received the block before general anesthesia by a single anesthetist (G.Ö.).

Results

The 24-h tramadol consumption with PCA, which was the primary outcome of the study, was determined to be statistically significantly less in the ESB group (p < 0.001). The NRS scores were compared at 30 min postoperatively and then at 1, 2, 4, 6, 12 and 24 h. At all the measured time points, the pain scores of the ESB group were statistically significantly lower (p < 0.001). Additional analgesia was required by one patient in the ESB group and by seven patients in the tumescent group and was applied as 1 g paracetamol. The requirement for additional analgesia was statistically significantly lower in the ESB group (p < 0.024). Patient satisfaction was statistically significantly better in the ESB group (p < 0.001).

Conclusions

According to the results of this study, bilateral ESB performed under ultrasound guidance in breast reduction surgery was more effective than tumescent anesthesia concerning postoperative analgesia consumption and pain scores. ESB could be an appropriate, effective and safe postoperative analgesia method for patients undergoing reduction mammoplasty surgery.

Level of Evidence II

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.

Keywords

Erector spinae block Mammoplasty Pain 

Notes

Acknowledgements

All the authors declare that they have all participated in the design, execution and analysis of the paper and that they have approved the final version. Additionally, there are no conflicts of interest in connection with this paper, and the material described is not under publication or consideration for publication elsewhere.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  • Gozen Oksuz
    • 1
  • Fatma Bilgen
    • 2
    Email author
  • Mahmut Arslan
    • 1
  • Yakup Duman
    • 3
  • Aykut Urfalıoglu
    • 1
  • Bora Bilal
    • 1
  1. 1.Anesthesiology and ReanimationKahramanmaraş Sutcu Imam University School of MedicineKahramanmarasTurkey
  2. 2.Plastic, Reconstructive and Aesthetic SurgeryKahramanmaraş Sutcu Imam University School of MedicineKahramanmarasTurkey
  3. 3.Plastic, Reconstructive and Aesthetic SurgeryTokat Gaziosmanpasa University School of MedicineTokatTurkey

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