POSTOPERATIVE ANALGESIC OUTCOMES OF DEXMEDETOMIDINE-AUGMENTED ERECTOR SPINAE PLANE BLOCK IN PATIENTS UNDERGOING MODIFIED RADICAL MASTECTOMY

Abstract

Background: Modified radical mastectomy (MRM) is commonly associated with moderate to severe postoperative pain, necessitating effective regional analgesic techniques. The erector spinae plane (ESP) block is a relatively novel fascial plane block that has shown promise in providing postoperative analgesia for breast surgeries. Dexmedetomidine, when used as an adjuvant to local anaesthetics, may enhance and prolong analgesic effects. Methods: This prospective observational study was conducted at Sree Mookambika Institute of Medical Sciences from March 2024 to March 2025. Thirty patients aged 25–60 years, belonging to ASA physical status I and II, scheduled for modified radical mastectomy were enrolled. An ultrasound-guided ipsilateral ESP block was administered preoperatively at the T3 or T4 vertebral level using 20 ml of 0.5% bupivacaine combined with 20 µg of dexmedetomidine. Postoperative pain was assessed using the visual analogue scale (VAS) at regular intervals for 24 hours. The collected data were analysed statistically. Results: All patients remained pain-free during the first 12 hours postoperatively. Two patients (6.66%) reported pain between 12 and 18 hours, while six patients (20%) experienced pain between 18 and 24 hours postoperatively. Overall analgesia was satisfactory with minimal requirement for rescue analgesics. Conclusion: Ultrasound-guided erector spinae plane block provides effective postoperative analgesia following modified radical mastectomy. The addition of dexmedetomidine to bupivacaine enhances the analgesic efficacy and prolongs the duration of postoperative pain relief.