ESPB vs TPVB in modified radical mastectomy

Abstract

Background: Effective pain management following modified radical mastectomy (MRM) is essential for patient comfort and recovery. Erector spinae plane block (ESPB) and thoracic paravertebral block (TPVB) have emerged as promising regional anesthesia techniques for postoperative pain control. This study aims to compare the analgesic efficacy, safety, and perioperative outcomes of ESPB and TPVB in patients undergoing MRM. Methods: 70 adult female patients, scheduled for modified radical mastectomy were randomized into two groups, Group P (n=35, received USG guided TPVB with 20 ml of 0.25% bupivacaine prior to GA) & Group E (n=35, received USG guided ESPB with 20 ml of 0.25% bupivacaine prior to GA). Heart Rate (HR), Mean Arterial Pressure (MAP), post-op VAS score, 1st analgesic request time, 24 hr morphine consumption & complications recorded. Results: 24 hr morphine consumption & 1st analgesic request time comparable between both groups (P = 0.32 and 0.075, respectively). No significant difference in the VAS scores between both groups. 4 patients in group P developed pneumothorax with no significant differences between both groups (P = 0.114). Nausea and vomiting incidence was comparable between both groups. Both groups showed stable hemodynamic profile. Conclusion: Both TPVB and ESPB provided effective post mastectomy analgesia and reduced both intra & post‑operative opioid consumption.