ArticlePerioperative medicine (London, England)2026
Comparison of erector spinae plane, paravertebral, and pectoral nerve blocks on postoperative analgesia and Quality of Recovery-15 in patients undergoing mastectomy: a prospective randomized trial.
Article in Perioperative medicine (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundModified radical mastectomy (MRM) is frequently associated with moderate to severe postoperative pain, which may negatively affect recovery and quality of life. Regional anesthesia techniques such as the erector spinae plane block (ESPB), thoracic paravertebral block (TPVB), and pectoral nerve block (PECS) have been increasingly used as part of multimodal analgesia strategies for breast surgery. However, their comparative effects on analgesic efficacy and quality of recovery remain unclear.
methodsThe study included 90 female patients undergoing unilateral elective MRM. Patients were randomly allocated into three groups (n = 30 each) to receive ESPB, TPVB, or PECS block preoperatively with 0.25% bupivacaine. All patients subsequently underwent standardized general anesthesia. Postoperative pain was assessed using the Visual Analog Scale (VAS) at 0, 1, 3, 6, 12, and 24 h. The primary outcome was total morphine consumption at 24 h. Secondary outcomes included time to first morphine request, incidence of rescue fentanyl use, postoperative nausea and vomiting, patient satisfaction, and scores.
resultsDemographic characteristics and operative durations were comparable among the groups (p > 0.05). Total 24-hour morphine consumption was significantly higher in the ESPB group (median 10 mg) compared with TPVB (9 mg, p = 0.009) and PECS (9 mg, p = 0.018) groups. Kaplan-Meier analysis revealed that the time to first morphine request was significantly shorter in the ESPB group (p < 0.001), while TPVB provided the longest analgesic duration. No significant differences were found in postoperative pain scores, rescue opioid requirements, or nausea-vomiting incidence (p > 0.05). QoR-15 scores were significantly lower in the ESPB group compared with TPVB and PECS groups (p < 0.001).
conclusionBoth PECS and TPVB provided superior postoperative analgesia and better quality of recovery scores compared to ESPB in patients undergoing modified radical mastectomy. These findings support the use of PECS or TPVB as effective components of multimodal analgesia strategies for breast cancer surgery.
trial registrationISRCTN Registry, ISRCTN17247698.
Indexed as
Identifiers
What OpenQuestion holds
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.