Comparative evaluation of continuous infusion versus intermittent bolus technique in ultrasound guided Erector Spinae Block in breast cancer patients undergoing modified radical mastectomy surgery- A randomized controlled trial

Breast surgery is an exceedingly common procedure and associated with an increased incidence of acute and chronic post surgical pain. Systemic opiods used in analgesia have the disadvantages of nausea, vomiting, respiratory depression and immune depression risking cancer patients to the risk of recurrence. Regional anaesthesia techniques may improve the postoperative analgesia for patients undergoing breast surgery and may even prevent the development of persistent post-surgical pain. Erector Spinae plane block is a recently discovered technique which provides better postoperative analgesia and the technique also lends itself to insertion of an indwelling catheter which can be used to extend the duration of analgesia as needed. After placing the catheter, local anaesthetic will be administered either as continuous infusion or intermittent boluses. However, there is limited literature to support the advantage of one technique over the other. This study hypothesizes that there will be less opioid consumption with intermittent bolus technique compared to continuous infusion technique as intermittent bolus technique is a volume dependent block and there will be wider coverage of required dermatome for analgesia.