Effects of erector spinae plane block on postoperative pain in patients undergoing implant-based breast reconstruction for breast cancer: a randomized controlled trial.

Authors

Dandan Ling, Shiyou Wei, Qianping He, Yulin Li, Qianyun Xu, Wei Jiao, Jun Zhang

Published in

Annals of medicine. Volume 58. Issue 1. Pages 2722439. Epub Sep 02, 2026.

Abstract

Implant-based breast reconstruction after mastectomy causes acute pain.
To determine whether a single-shot T5 erector spinae plane block (ESPB) reduces postoperative pain.
Single-center, RCT with allocation concealment; blinded assessors and statisticians.
Tertiary cancer center in China.
100 adults scheduled for radical mastectomy with implant reconstruction were randomized (1:1); follow-up complete.
Before induction, ESPB was given under ultrasound guidance at T5 with 30 mL of 0.375% ropivacaine plus dexmedetomidine 1 μg/kg; controls received no block. Standardized general anesthesia and postoperative PCA for both groups.
Resting NRS at 6 h (MCID=1). Secondary outcomes were opioid consumption, quality of recovery, and PONV.
ESPB did not significantly reduce resting pain at 6 h at the median (τ =0.50; adjusted difference -0.9; p = 0.08). At the upper tail, pain intensity was lower (τ = 0.75; -1.8; p <0.01). Repeated measures provided additional time-point information, improving estimation precision and test sensitivity. ESPB get lower pain scores at 6, 12, and 24 hours (all p <0.01). But, the 95% CI includes the MCID, the clinical benefit remains uncertain. Opioid use decreased at 24 h (-13.5 mg; p <0.01) and 48 h (-6.6 mg; p <0.01). Quality of recovery improved at 24 h (difference 5 points; p <0.01), but not later. No differences were observed in intraoperative hemodynamics or PONV.
Single-shot T5 ESPB with perineural dexmedetomidine may reduce postoperative pain and opioid requirements and improve early recovery. Further large trials are warranted. Clinical relevance remains to be confirmed.
ClinicalTrials.gov NCT06143020.

PMID:
42686359
Bibliographic data and abstract were imported from PubMed on 03 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.