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
Authors' conclusion
Both PECS and TPVB provided superior postoperative analgesia and better quality of recovery scores compared to ESPB in patients undergoing modified radical mastectomy.
Study context
- Population
- Female patients undergoing unilateral elective modified radical mastectomy under GA
- Participants
- 90 patients
- Comparison
- Erector spinae plane block (ESPB) vs thoracic paravertebral block (TPVB) vs PECS block
- ESPBn = 30
- TPVBn = 30
- PECSn = 30
- Primary endpoint
- Total morphine consumption
- Follow-up
- 24 h
Methodological detailsprospective
- Prospective
Primary result
As reported in the abstract
Total 24-hour morphine consumption
ESPB
10
median · mg
TPVB
9
mg
PECS
9
mg
ESPB vs TPVB: P = 0.009 · ESPB vs PECS: P = 0.018
Secondary outcomes
Time to first morphine request (Kaplan-Meier)
- Significantly shorter in ESPB; TPVB provided the longest analgesic duration
- P < 0.001
Postoperative pain scores (Visual Analog Scale (VAS)) and rescue opioid requirements
- No significant differences among groups
- P > 0.05
QoR-15 scores
- Significantly lower in ESPB vs TPVB and PECS
- P < 0.001
Safety
PONV incidence
- No significant differences among groups
- P > 0.05
Original publication
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. Perioper Med (Lond). Published 6 June 2026. doi:10.
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