Evidence map›Paper›PMID 36253729›Full record

Trial reportBMC anesthesiology2022

Analgesia and spread of erector spinae plane block in breast cancer surgeries: a randomized controlled trial.

Ahmed Mohamed Mohamed Rabah Abdella, Emad Eldin Abd El Monem Arida, Nagwa Ahmed Megahed, Wessam Zakaria El-Amrawy, Walid Mohamed Ahmed Mohamed

Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC anesthesiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04796363 (Ultrasound Guided Erector Spinae Plane Block in Breast Cancer Surgery), which is not on this map. Cited by 21 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 1 pooled it
5.2field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04796363 nacompletednot on this map

Ultrasound Guided Erector Spinae Plane Block in Breast Cancer Surgery: Analgesia, Spread and Immunomodulation

TypeinterventionalSponsorAlexandria UniversityRan2020 to 2022Enrolled60ConditionsAnalgesia, Breast CancerArmsErector Spinae Plane Block with Bubivacaine, Standard General Anaesthesia
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.

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  15. The Utility of Erector Spinae Plane Blocks in Breast Surgery: A Practical Review.Plastic and reconstructive surgery. Global open · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Ahmed Mohamed Mohamed Rabah AbdellaDepartment of Anesthesia and Pain Management, Medical Research Institute, University of Alexandria, 165 El-Horeya Rd, Al Ibrahimeyah Qebli WA Al Hadrah Bahri, Qesm Bab Sharqi, Alexandria, Egypt. Ahmed.rabah@alexu.edu.eg.
Emad Eldin Abd El Monem AridaDepartment of Anesthesia and Surgical Intensive Care, Faculty of Medicine, University of Alexandria, Alexandria, Egypt.
Nagwa Ahmed MegahedDepartment of Anesthesia and Pain Management, Medical Research Institute, University of Alexandria, 165 El-Horeya Rd, Al Ibrahimeyah Qebli WA Al Hadrah Bahri, Qesm Bab Sharqi, Alexandria, Egypt.
Wessam Zakaria El-AmrawyDepartment of Anesthesia and Pain Management, Medical Research Institute, University of Alexandria, 165 El-Horeya Rd, Al Ibrahimeyah Qebli WA Al Hadrah Bahri, Qesm Bab Sharqi, Alexandria, Egypt.
Walid Mohamed Ahmed MohamedDepartment of Diagnostic Radiology, Medical Research Institute, University of Alexandria, Alexandria, Egypt.
Alexandria University · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo evaluate the analgesic efficacy and spread of variable volumes of local anesthetics (LA) in Erector spinae plane block (ESPB).

methodsSixty patients aged between 18 and 50 years with an ASA I-II and scheduled for breast cancer surgery were randomized to receive either ESPB with 20 ml 0.25% bupivacaine (Standard volume ESPB), or with 40 ml 0.125% bupivacaine (High volume ESPB), or no ESPB (GA only group). The primary outcome was pain intensity evaluated by the visual analogue scale (VAS), 12 hours after surgery. P-values < 0.05 were considered the cutoff point for statistical significance. The secondary outcomes were pain at rest and pain on movement evaluated by the VAS, craniocaudal injectate spread, to paravertebral (PV) and epidural spaces assessed by CT, clinical dermatomal spread, level of sedation or agitation, and patient satisfaction with anesthesia and analgesia.

resultsVAS at rest 12 h after surgery was less in both intervention groups compared to the control (1.75 ± 0.79 vs. 1.6 ± 0.88 vs. 3.4 ± 1.96, p = 0.001). The LA had extended further in the high volume group than the standard volume group (11.20 ± 3.07 vs. 9.15 ± 2.54 vertebral levels, p = 0.027). No difference of the spread to PV or epidural spaces between the 2 intervention groups. More dermatomes were covered in the high volume group (7.20 ± 2.12 vs. 5.75 ± 1.37 dermatomes, p = 0.014). Agitation was higher in the GA only group than both ESPB groups in the first 8 postoperative hours. Patients were more satisfied in both ESPB groups than the GA only group.

conclusionsPreoperative ESPB is an excellent analgesic modality and it can also attenuate both postoperative agitation and sedation. Doubling the injectate volume enhances the craniocaudal spreading and may be useful for surgeries requiring multiple dermatomes. However, larger volume has no effect on analgesic efficacy or patient satisfaction as there is no further spread to the PV, epidural spaces or spinal nerve rami.

trial registrationNCT04796363 (12/3/2021).

Indexed as

Breast NeoplasmsNerve BlockAdolescentAdultAnalgesia, Patient-ControlledAnesthetics, LocalBupivacaineFemaleHumansMiddle AgedPostoperative PainUltrasonography, InterventionalYoung AdultAnesthetics, LocalBupivacaineAnalgesiaand Breast cancer surgeryErector spinae plane blockSpreadUltrasound guided

Identifiers

PMID36253729
PMCPMC9575234
OpenAlexW4306403402

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.