Effect of preoperative ultrasound-guided thoracic interfacial plane block versus preoperative thoracic erector spinae plane block on acute and chronic pain after modified radical mastectomy: A randomized controlled trial

ABSTRACT Background More than 50% of individuals who have breast surgery have acute postoperative pain, and 8% among those patients endure persistent severe pain. The purpose of this study was to evaluate the efficiency of ultrasound-guided thoracic inter-fascial plane block (US-guided TIFPB) and ultrasound guided erector spinae plane block (US-guided ESPB) on acute and chronic pain following modified radical mastectomy (MRM) surgeries. Methods 90 female participants who were hospitalized for unilateral MRM surgery underwent this prospective randomized controlled trial. Patients were split into three equal groups at random: Group I: received preoperative TIFPB, group II: received preoperative ESPB, group III: received preoperative sham block (control group). Results VAS was considerably lower in group I at 12 h (P1 = 0.029) and when group III is compared with groups I and II at 2, 4, 6, 12, 18 and 24 h (P < 0.05). First analgesic requires was greatly delayed in time and total morphine consumption was significantly decreased compared to group III in groups I and II (P < 0.001) and was insignificantly different between both groups I and II. Chronic pain 3, 6 months postoperative was markedly decreased in comparison to group III in groups I and II (P < 0.05). Conclusions TIFPB and ESPB were comparable, both were superior to control in terms of lower intraoperative fentanyl consumption, pain score, first analgesic requirement onset is delayed, lower total consumption of morphine, chronic pain 3 and 6 months postoperatively. TIFPB showed a lower pain score at 12 hr. postoperatively compared to ESPB.