Effect of ultrasound-guided stellate ganglion block combined with erector spinal plane block on postoperative recovery quality of breast cancer patients: a randomized controlled trial

Background There are many reports demonstrating that regional anaesthesia improves the quality of postoperative recovery in patients undergoing breast cancer surgery; however, the enhancement of the quality of postoperative recovery by a combined block of regional anaesthesia has rarely been investigated. We compared whether stellate ganglion block (SGB) combined with erector spinal plane block (ESPB) was more effective than ESPB alone in improving the quality of postoperative recovery in female patients undergoing unilateral modified radical mastectomy (MRM) . Methods Ninety female patients were selected for elective proposed unilateral modified radical mastectomy and randomly divided into combined block group (SE group) and control group (E group), with 45 cases in each group. The same anesthetic drugs were used for induction and maintenance in both groups, and ultrasound-guided right stellate ganglion block combined with a plane block of the affected erector spinae muscle was performed 15 min before induction of anesthesia in the SE group, while only a plane block of the affected erector spinae muscle was performed in the E group. QoR-15 scores on the first postoperative day and postoperative visual analog scores (VAS) at different time points were observed in both groups; intraoperative opioid use was observed in both groups. Results QoR-15 scores on the first postoperative day were significantly improved in the SE group (122.91 ± 6.15) compared with the E group (114.80 ± 7.01) (P < 0.05); the SE group showed lower VAS scores than the E group at 12h and 24h postoperatively in the resting (1.53 ± 0.50, 1.02 ± 0.69; 1.80 ± 0.54, 1.51 ± 0.62, respectively) and active (respectively 2.42±0.49, 1.80±0.58; 3.16±0.52, 2.31±0.46) states(P<0.05); intraoperative remifentanil use was lower in the SE group (487.11±26.59ug, 570.67±31.29ug, respectively, P<0.05). Conclusion After unilateral MRM, the combined block group was more effective than ESPB alone in reducing opioid consumption and lowering postoperative VAS scores, improving the quality of patients' postoperative recovery.