Evidence map›Paper›PMID 39816904›Full record

ArticlePain reports2025

Role of bilevel erector spinae with high thoracic block vs conventional unilevel block in analgesia and reduction of pain in axilla in breast cancer surgeries: a randomized controlled trial.

Walaa Y Elsabeeny, Reham M Fahmy, Fatma H Elshamy, Nahla N Shehab, Sayed M Abed, Walid S Taha, Mostafa A Ibrahim, Ahmed F Gad

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pain reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07022353 (Ultrasound-guided Bi-level Erector Spinae Plane Block and Pre-emptive Single-dose Oral Tizanidine for Postoperative Analgesia After Mastectomy Surgery), which is not on this map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT07022353 nacompletednot on this map

Ultrasound-guided Bi-level Erector Spinae Plane Block and Pre-emptive Single-dose Oral Tizanidine for Postoperative Analgesia After Mastectomy Surgery: a Prospective, Randomized, Controlled Trial

TypeinterventionalSponsorMansoura UniversityRan2025 to 2025Enrolled90ConditionsMastectomy PatientArmsBilevel erector spinae plane block, Placebo Oral Capsule, tizanidine oral capsule
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
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

8 authors.

Walaa Y ElsabeenyDepartment of Anaesthesia, Surgical Critical Care and Pain Management, National Cancer Institute-Cairo University, Cairo, Egypt.ORCID https://orcid.org/0000-0003-3047-6926
Reham M FahmyDepartment of Anaesthesia, Surgical Critical Care and Pain Management, National Cancer Institute-Cairo University, Cairo, Egypt.
Fatma H ElshamyDepartment of Anaesthesia, Surgical Critical Care and Pain Management, National Cancer Institute-Cairo University, Cairo, Egypt.
Nahla N ShehabDepartment of Anaesthesia, Surgical Critical Care and Pain Management, National Cancer Institute-Cairo University, Cairo, Egypt.
Sayed M AbedDepartment of Anaesthesia, Surgical Critical Care and Pain Management, National Cancer Institute-Cairo University, Cairo, Egypt.
Walid S TahaDepartment of Anaesthesia, Intensive Care and Pain Management, Faculty of Medicine-Cairo University, Cairo, Egypt.
Mostafa A IbrahimDepartment of Anaesthesia, Surgical Critical Care and Pain Management, National Cancer Institute-Cairo University, Cairo, Egypt.
Ahmed F GadDepartment of Anaesthesia, Surgical Critical Care and Pain Management, National Cancer Institute-Cairo University, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: Management of pain associated with breast cancer surgeries is crucial in reducing incidence of postmastectomy pain syndrome. The pain distribution involves the anterior chest wall, axillary area and ipsilateral upper limb. Objective: This study was designed to investigate the effect of bilevel erector spinae plane block (ESPB) with high thoracic block vs the conventional unilevel ESPB vs opioids in patients with cancer undergoing modified radical mastectomy regarding pain control and reducing pain in axilla. Methods: One hundred twenty-six female patients with cancer and American Society of Anesthesiology II, III were randomized into 3 groups: bilevel ESPB, unilevel ESPB, and control group. The primary outcome was total postoperative morphine consumption. Results: Total postoperative morphine consumption was higher for the control group compared with the bilevel and unilevel groups (5.5 ± 1.8 vs 3.0 ± 0.0 and 4.3 ± 1.6 mg, Conclusion: Both conventional unilevel and high thoracic bilevel ESPB had better analgesic profile when compared with opioids. Although the bilevel ESPB had additional merits to the unilevel ESPB in analgesic effects, both can be used effectively.

Indexed as

AnalgesiaBreastCancerESPBMorphinePain

Identifiers

PMID39816904
PMCPMC11732649

What OpenQuestion holds

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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.