Trial reportThe breast journal2026
Comparison of Modified Pectoral Nerve Block and Erector Spinae Plane Block for Postoperative Analgesia and Surgical Stress Response Following Modified Radical Mastectomy: A Prospective, Randomised, Blinded Study.
Trial report in The breast journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
4 authors.
Funding
Abstract
backgroundErector spinae plane block (ESPB) and modified pectoral nerve block (PECS-II) are being increasingly used to control pain following breast surgeries. However, evidence comparing their effects on postoperative analgesia and surgical stress response is limited. The current study compared analgesic efficacy and surgical stress response attenuation of ESPB and PECS-II in patients undergoing modified radical mastectomy (MRM).
methodsIn this prospective, randomised, comparative study, 42 patients undergoing elective MRM were randomly divided to receive either ESPB or PECS-II. Both groups received 30 mL of 0.2% ropivacaine with 0.5 μg/kg dexmedetomidine after induction of general anaesthesia (GA). The primary outcome was time to first rescue analgesia requirement. Secondary outcomes were postoperative numerical rating scale (NRS) scores, rescue analgesic consumption, intraoperative fentanyl requirement, serum cortisol, interleukin-6 (IL-6) and neutrophil-to-lymphocyte ratio (NLR), patient satisfaction and block-related complications.
resultsThe mean time to first rescue analgesia was significantly larger in the PECS-II group than in the ESPB group (9.05 ± 1.12 h vs 6.95 ± 1.16 h; p < 0.001). Patients receiving PECS-II had lower 24-h diclofenac (114.3 ± 38.4 mg vs 146.4 ± 16.4 mg; p = 0.002) and tramadol consumption (7.1 ± 17.9 mg vs 23.8 ± 25.6 mg; p = 0.021). NRS scores were lower in the PECS-II group at 6 h postoperatively (p < 0.001). Intraoperative fentanyl requirement was comparable between the two groups (p = 0.133). Postoperative serum cortisol (363.48 ± 41.79 vs 495.95 ± 52.20 nmol/L), IL-6 (14.48 ± 4.39 vs 24.43 ± 6.33 pg/mL) and NLR (4.15 ± 0.55 vs 4.98 ± 0.85) were also lower in the PECS-II group (p ≤ 0.001). Patient satisfaction scores were higher following PECS-II (5.62 ± 0.74 vs 5.05 ± 0.67; p = 0.022). No block-related complications were observed in either group.
conclusionPECS-II provided longer postoperative analgesia than ESPB in patients undergoing MRM under GA. Exploratory analyses showed lower postoperative analgesic consumption, lower pain scores at 6 h, lower postoperative stress response markers and higher patient satisfaction with PECS-II. These secondary findings should be considered hypothesis-generating and warrant confirmation in larger, adequately powered studies. Intraoperative fentanyl requirement was comparable between the two groups.
trial registrationClinical Trials Registry: CTRI/2024/04/066198.
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