Comparison of ultrasound guided erector spinae block versus paravertebral block for post operative analgesia in breast surgeries

The comparison of ultrasound-guided erector spinae block (ESB) versus paravertebral block (PVB) in breast surgeries, particularly when using levobupivacaine as an analgesic.

Erector Spinae Block (ESB): Involves injecting anesthetic in the fascial plane deep to the erector spinae muscle, targeting the dorsal rami of the spinal nerves. It provides analgesia by spreading along the paravertebral space and affecting multiple dermatomes.

-Paravertebral Block (PVB): Involves injecting anesthetic into the paravertebral space, directly affecting the spinal nerves. This can provide more targeted analgesia for specific dermatomes.

Both blocks are effective for postoperative pain relief in breast surgeries. Some studies suggest that PVB may provide better analgesia due to its direct targeting of the intercostal nerves.

Technical Considerations

• Ultrasound Guidance: Both techniques benefit from ultrasound guidance, improving accuracy and reducing complication rates. ESB is often easier to perform and visualize compared to PVB.

-In breast surgeries using levobupivacaine, both the erector spinae block and paravertebral block provide effective analgesia. The choice between them may depend on the specific surgical procedure, the expertise of the clinician, and patient factors. Further research comparing these techniques directly in large-scale studies would help clarify their relative benefits and optimal usage.

Levobupivacaine is less cardio toxic compared to other analgesia