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Randomized Controlled Trial
. 2025 Sep 12;104(37):e44466.
doi: 10.1097/MD.0000000000044466.

Comparison of erector spinae plane block and tramadol on postoperative systemic immune-inflammatory response in breast cancer surgery: A prospective randomized controlled trial

Ezgi Gülay  1 , Ahmet Gültekin  1 , İlker Yildirim  1 , Cavidan Arar  1 , Sibel Özkan Gürdal  2
Affiliations
Randomized Controlled Trial

Comparison of erector spinae plane block and tramadol on postoperative systemic immune-inflammatory response in breast cancer surgery: A prospective randomized controlled trial

Ezgi Gülay et al. Medicine (Baltimore). .

Abstract

Background: Breast cancer is the most commonly diagnosed malignancy and the leading cause of cancer-specific deaths among women. This study aimed to compare the effects of erector spinae plane block (ESPB) and systemic tramadol use as postoperative analgesia methods on the systemic immune-inflammatory index (SII) in patients undergoing breast cancer surgery.

Methods: A total of 120 patients were included in the study and divided into 2 groups of 60 each based on the analgesia method: Group E (receiving ESPB) and Group T (receiving tramadol). SII values were measured and analyzed in both preoperative and postoperative periods.

Results: In Group T, a significant increase of 1211.78 ± 1345.34 units in postoperative SII measurements compared to the preoperative period was observed (P < .01). In Group E, a significant decrease of 498.36 ± 786.25 units in postoperative SII measurements compared to the preoperative period was noted (P < .01).

Conclusion: ESPB was found to provide more effective postoperative analgesia by reducing opioid consumption and demonstrated beneficial effects on inflammatory markers.

Trial registration: ClinicalTrials.gov NCT06954324.

Keywords: breast cancer; erector spinae plane block (ESPB); stress response; systemic immune-inflammatory index (SII).

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
Preparation for the ESPB procedure prior to block administration, T4: Thoracic vertebra spinous process landmark, X: ESPB application point. ESPB = erector spinae plane block.
Figure 2.
Figure 2.
Sonoanatomy of ESPB. TK = trapezius muscle, RK = rhomboid muscle, ESK = erector spinae muscle, TP = transverse process, ESPB = erector spinae plane block.
See this image and copyright information in PMC

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