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

Figures & data

Figure 1. Randomized trial flow diagram, including enrollment, intervention allocation, follow up and analysis.

Table 1. Patient characteristics among the three groups.

	Group I (n = 30)	Group II (n = 30)	Group III (n = 30)	P value
Age (years)	56.2 ± 9.99	55.57 ± 10.03	53.4 ± 10.28	0.533
Weight (kg)	76.7 ± 12.06	82.67 ± 11.94	78.03 ± 12.87	0.149
Duration of surgery (min)	98.07 ± 5.58	96.77 ± 5.76	97.7 ± 5.68	0.659

Data are presented as mean ± SD.

Figure 2. Intraoperative (A) MAP, (B) HR and postoperative (C) MAP, (D) HR among the three groups.

Table 2. Time of first analgesic requirement (h), total morphine consumption (mg), cortisol levels, random blood sugar and patient satisfaction among the three group.

		Group I (n = 30)	Group II (n = 30)	Group III (n = 30)	P value	Significance between groups
Intraoperative incremental fentanyl consumption (mic)		0 (0–30)	0 (0–30)	30 (30–30)	<0.001*	P1 = 0.409 P2 < 0.001* P3 < 0.001*
Time of first analgesic requirement (h)		18.466 ± 5.19	17 ± 4.48	4.4 ± 1.52	<0.001*	P1 = 0.059 P2 < 0.001* P3 < 0.001*
Total morphine consumption (mg)		5.47 ± 2.06	6.43 ± 2.25	10.87 ± 2.46	<0.001*	P1 = 0.229 P2 < 0.001* P3 < 0.001*
Cortisol levels (mcg/dL)	Before surgery	20.24 ± 5.87	18.6 ± 5.96	20.01 ± 5.76	0.505	P1 = 0.527 P2 = 0.988 P3 = 0.621
	6 h postoperative	16.82 ± 5.42	15.14 ± 5.59	31.56 ± 7.79	<0.001*	P1 = 0.585 P2 < 0.001* P3 < 0.001*
Random blood sugar (mg/dl)	Before surgery	88.53 ± 12.98	92.5 ± 11.72	88.47 ± 12.98	0.368	–
	20 minutes postoperative	94.7 ± 8.23	103.03 ± 17.93	145.27 ± 16.74	<0.001*	P1 = 0.084 P2 < 0.001* P3 < 0.001*
	8 h postoperative	98.87 ± 9.73	98.83 ± 9.68	123.87 ± 18.73	<0.001*	P1 = 1 P2 < 0.001* P3 < 0.001*
	16 h postoperative	92.7 ± 8.23	97.8 ± 9.73	123.67 ± 18.33	<0.001*	P1 = 0.281 P2 < 0.001* P3 < 0.001*
	24 h postoperative	97.53 ± 21.57	97.67 ± 11.05	122.33 ± 19.07	<0.001*	P1 = 1 P2 < 0.001* P3 < 0.001*
Patient satisfaction in 24 h	Unsatisfied	2 (6.7%)	2 (6.7%)	16 (53.3%)	<0.001*	P1 = 0.698 P2 < 0.001* P3 < 0.001*
	Fair	1 (3.3%)	5 (16.7%)	9 (30.0%)
	Satisfied	27 (90.0%)	23 (76.7%)	5 (16.7%)

Data expressed as median (IQR), mean ± SD or frequency (%), *Significant as P value < 0.05, P1: (P value between group I and group II), P2: (P value between group I than group III), P3: (P value between group II and group III).

Figure 3. VAS among the three group.

Table 3. Occurrence of chronic pain at 3 and 6 months after surgery, and adverse events among the three group.

		Group I (n = 30)	Group II (n = 30)	Group III (n = 30)	P value	Significance between groups
Chronic pain 3 months after surgery		9 (30.0%)	11 (36.7%)	19 (63.3%)	0.002*	P1 = 0.583 P2 = 0.009* P3 = 0.039*
Chronic pain 6 months after surgery		7 (23.3%)	8 (26.7%)	17 (56.7%)	0.011*	P1 = 0.766 P2 = 0.008* P3 = 0.018*
Adverse events	Bradycardia	5 (14.3%)	3 (8.6%)	2 (5.7%)	0.455	—-
	Hypotension	6 (17.1%)	8 (22.9%)	7 (20.0%)	0.738	—-
	Drowsiness	0 (0.0%)	0 (0.0%)	0 (0.0%)	—-	—-
	Dizziness	0 (0.0%)	0 (0.0%)	0 (0.0%)	—-	—-
	LAST	0 (0.0%)	0 (0.0%)	0 (0.0%)	—-	—-

Data expressed as mean ± SD and frequency (%), *Significant as P value < 0.05, P1: (P value between group I and group II), P2: (P value between group I than group III), P3: (P value between group II and group III).