{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:17:53Z","timestamp":1792808273286,"version":"4.5.0"},"reference-count":20,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2026,6,23]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The paravertebral block is considered the gold standard for regional anesthesia in breast surgery; however, it carries an elevated risk of pneumothorax. The erector spinae plane (ESP) block is thought to be safer. We sought to evaluate outcomes following breast reduction mammoplasty in patients treated with ESP block plus standard analgesia versus standard analgesia alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>78 patients were randomized to either the ESP block group or the standard analgesia group. Participants in the block group received bilateral ultrasound-guided ESP blocks with 30\u2009mL of 0.25% ropivacaine per side at the T4 level.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The block group reported a clinically insignificant reduction in the mean cumulative dose of oral morphine milligram equivalents used in the 24 hours postsurgery when compared with the no-block group (10.6 vs 17.5; p=0.014). Patients who received a block were discharged a mean of 170\u2009min after post-anesthesia care unit (PACU) admission compared with the no-block group of 213\u2009min (p=0.012). Nausea and vomiting in PACU, pain at discharge, 24-hour pain scores, and overall anesthesia satisfaction scores were not significantly different between the groups. Any opioid use during the PACU stay was significantly less in the block group, with only 59% of patients in the block group requiring opioids versus 86.8% in the no-block group (p=0.006).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An ESP block prior to breast reduction mammoplasty did not translate to a clinically meaningful reduction in opioid usage in the immediate postoperative period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03954249\">NCT03954249<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2026-107819","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:05:23Z","timestamp":1783595123000},"page":"rapm-2026-107819","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluating the effectiveness of bilateral erector spinae plane blocks in addition to standard multimodal analgesia at reducing opioid consumption in patients undergoing elective mammoplasty in an ambulatory surgical center: a randomized clinical trial"],"prefix":"10.1136","clinical-trial-number":[{"clinical-trial-number":"nct03954249","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03954249","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7874-7379","authenticated-orcid":false,"given":"Rafi","family":"Khandaker","sequence":"first","affiliation":[{"name":"Anesthesiology, Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9208-291X","authenticated-orcid":false,"given":"Tanzib","family":"Razzaki","sequence":"additional","affiliation":[{"name":"Anesthesiology, University of Rochester Medical Center, Rochester, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda","family":"Aquino","sequence":"additional","affiliation":[{"name":"Anesthesiology, Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Bui","sequence":"additional","affiliation":[{"name":"Anesthesiology, UC Davis Health, Sacramento, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Labins","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Randolph","sequence":"additional","affiliation":[{"name":"Anesthesiology, Northwell Health, Bay Shore, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Anesthesiology\/Pain Management, Yale New Haven Health, Greenwich, Connecticut, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Curtis","family":"Choice","sequence":"additional","affiliation":[{"name":"Anesthesiology, Northwell Health, Bay Shore, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Anesthesiology, Cooperman Barnabas Medical Center, Livingston, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3138-2606","authenticated-orcid":false,"given":"Elilary","family":"Montilla Medrano","sequence":"additional","affiliation":[{"name":"Anesthesiology, Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"2026070904051462000_rapm-2026-107819v1.1","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1007\/s11606-015-3539-4","article-title":"Opioid Prescribing at Hospital Discharge Contributes to Chronic Opioid Use","volume":"31","author":"Calcaterra","year":"2016","journal-title":"J Gen Intern Med"},{"key":"2026070904051462000_rapm-2026-107819v1.2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003265"},{"key":"2026070904051462000_rapm-2026-107819v1.3","doi-asserted-by":"crossref","DOI":"10.5812\/aapm.101339","article-title":"Risk of Opioid 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Postoperative Nausea and Vomiting after Inpatient and Outpatient Breast Surgery: Incidence and Effects of Midazolam. 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