Revista Cultura Científica
Comparison of Postoperative Pain After Modified Radical Mastectomy Using Erector Spinae Plane Block with Bupivacaine Plus Dexmedetomidine versus Bupivacaine Alone
By Ayesha Siddiqa and Muzammil Hussain.
Abstract
Background
Modified radical mastectomy (MRM), particularly when accompanied by axillary dissection, can cause substantial acute postoperative pain and may contribute to persistent postsurgical pain. Ultrasound-guided erector spinae plane block (ESPB) is used as a component of multimodal analgesia, and dexmedetomidine has been investigated as an adjuvant to prolong local-anaesthetic effects.
Objective
To compare postoperative pain scores and rescue-analgesia requirements after MRM in patients receiving ESPB with bupivacaine plus dexmedetomidine versus bupivacaine alone.
Methods
This single-centre randomized controlled trial was conducted in the Department of Anaesthesiology, ICU and Pain Management, Sir Ganga Ram Hospital, Lahore, Pakistan, from March to June 2026. Sixty women with American Society of Anesthesiologists (ASA) physical status I–II who were scheduled for elective MRM under general anaesthesia were allocated by lottery to two equal groups (n=30 each). A unilateral ultrasound-guided ESPB was performed at the T4 level after surgery. Group BD received 20 mL of 0.25% bupivacaine with dexmedetomidine 1 μg/kg, whereas Group B received 20 mL of 0.25% bupivacaine without dexmedetomidine. Pain intensity was assessed using a 10-cm visual analogue scale (VAS) at 1, 12 and 24 hours postoperatively.