{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:33:42Z","timestamp":1786739622787,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims:<\/jats:title>\n                    <jats:p>Fascial plane blocks have emerged as a promising element for multimodal analgesia in breast surgeries. This study aimed to compare intra-operative and post-operative opioid requirements following costotransverse block (CTB) and erector spinae plane block (ESPB) for perioperative analgesia in patients scheduled for modified radical mastectomy (MRM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Sixty patients aged 25 to 65 years scheduled for MRM were randomised to receive either CTB or ESPB with 25 ml of 0.5% bupivacaine. The primary outcome was to compare the effectiveness of these two blocks in reducing the consumption of opioids for post-operative pain relief, measured by 24-hour morphine requirement. Secondary outcomes included time required to perform the block, intra-operative haemodynamics, total intra-operative fentanyl requirement, post-operative nausea and vomiting (PONV), and any complications related to the blocks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The numeric rating scale scores were comparable between the groups at all time points during the 24-hour post-operative period. The rescue analgesic requirement (morphine), median (interquartile range) was similar in the CTB group (3\n                      <jats:sup>[3, 3]<\/jats:sup>\n                      mg) and in the ESPB group (3 [3, 3.75] mg) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 1.00). The intra-operative fentanyl requirement median (interquartile range) was significantly higher in the ESPB group, 100 (100, 150) \u03bcg, than in the CTB group, 100 (100, 100) \u03bcg (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.006). Incidence of PONV was comparable between the groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Both CTB and ESPB are comparable in providing post-operative analgesia for MRM patients. However, CTB likely offers better intra-operative analgesia as observed by the lower intra-operative opioid requirement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ija.ija_1256_25","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T16:00:42Z","timestamp":1779292842000},"page":"662-668","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of costotransverse block and erector spinae plane block for perioperative analgesia in patients scheduled for modified radical mastectomy \u2013 A pilot study"],"prefix":"10.4103","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7928-7052","authenticated-orcid":false,"given":"Aanchal R.","family":"Bharuka","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Surgical Intensive Care Unit, Pain and Palliative Medicine, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5080-2427","authenticated-orcid":false,"given":"Dhanya G.","family":"Nayak","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Surgical Intensive Care Unit, Pain and Palliative Medicine, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6786-7117","authenticated-orcid":false,"given":"Vibhavari Milind","family":"Naik","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Surgical Intensive Care Unit, Pain and Palliative Medicine, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9023-8113","authenticated-orcid":false,"given":"Basanth K.","family":"Rayani","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Surgical Intensive Care Unit, Pain and Palliative Medicine, Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"R1-20260520","doi-asserted-by":"crossref","first-page":"S77","DOI":"10.21037\/tcr.2019.06.46","article-title":"Post-mastectomy and post-breast conservation surgery pain syndrome:A review of etiologies, risk prediction, and trends in management","volume":"9","author":"Chen","year":"2020","journal-title":"Transl Cancer Res"},{"key":"R2-20260520","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1186\/s12871-018-0667-5","article-title":"Inadvertent posterior intercostal artery puncture and haemorrhage after ultrasound-guided thoracic paravertebral block:A case report","volume":"18","author":"Song","year":"2018","journal-title":"BMC Anesthesiol"},{"key":"R3-20260520","doi-asserted-by":"crossref","first-page":"27","DOI":"10.33545\/26648849.2024.v6.i1a.40","article-title":"ESPB vs TPVB in modified radical mastectomy","volume":"6","author":"Venu","year":"2024","journal-title":"Int J Anesthesiol Res"},{"key":"R4-20260520","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1016\/j.bja.2024.10.046","article-title":"Spread of local anaesthetic after erector spinae plane block:A randomised, three-dimensional reconstruction, imaging study","volume":"134","author":"Shan","year":"2025","journal-title":"Br J Anaesth"},{"key":"R5-20260520","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1111\/aas.13424","article-title":"Are single-injection erector spinae plane block and multiple-injection costotransverse block equivalent to thoracic paravertebral block?","volume":"63","author":"Nielsen","year":"2019","journal-title":"Acta Anaesthesiol Scand"},{"key":"R6-20260520","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1186\/s12871-022-01651-3","article-title":"Use of ultrasound guided single shot costotransverse block (intertransverse process) in breast cancer surgery:A prospective, randomized, assessor blinded, controlled clinical trial","volume":"22","author":"Aygun","year":"2022","journal-title":"BMC Anesthesiol"},{"key":"R7-20260520","doi-asserted-by":"crossref","first-page":"2427","DOI":"10.2147\/JPR.S518558","article-title":"Comparison of costotransverse foramen block with thoracic paravertebral block and erector spinae plane block for patients undergoing video-assisted thoracoscopic surgery:A randomized controlled non-inferiority trial","volume":"18","author":"Li","year":"2025","journal-title":"J Pain Res"},{"key":"R8-20260520","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1177\/0962280215588241","article-title":"Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable","volume":"25","author":"Whitehead","year":"2016","journal-title":"Stat Methods Med Res"},{"key":"R9-20260520","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1186\/s12871-023-02264-0","article-title":"The effect of body mass index on thoracic paravertebral block analgesia after video-assisted thoracoscopic surgery:A prospective interventional study","volume":"23","author":"Zengin","year":"2023","journal-title":"BMC Anesthesiol"},{"key":"R10-20260520","doi-asserted-by":"crossref","first-page":"772","DOI":"10.4103\/ija.ija_535_21","article-title":"Multiple injection costotransverse block for chronic pain in a patient with granulomatous mastitis","volume":"65","author":"Nanda","year":"2021","journal-title":"Indian J Anaesth"},{"key":"R11-20260520","doi-asserted-by":"crossref","first-page":"e6667","DOI":"10.1097\/GOX.0000000000006667","article-title":"The utility of erector spinae plane blocks in breast surgery:A practical review","volume":"13","author":"Raborn Macdonald","year":"2025","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"R12-20260520","doi-asserted-by":"crossref","first-page":"489","DOI":"10.4103\/ija.ija_812_24","article-title":"Ultrasound-guided subtransverse interligamentary (STIL) block versus erector spinae plane (ESP) block for postoperative analgesia in patients scheduled for modified radical mastectomy (MRM) \u2013A randomised comparative study","volume":"69","author":"Anand","year":"2025","journal-title":"Indian J Anaesth"},{"key":"R13-20260520","doi-asserted-by":"crossref","first-page":"209","DOI":"10.4097\/kja.d.19.00012","article-title":"The erector spinae plane block:A narrative review","volume":"72","author":"Kot","year":"2019","journal-title":"Korean J Anesthesiol"},{"key":"R14-20260520","doi-asserted-by":"crossref","first-page":"22","DOI":"10.4103\/sja.SJA_260_19","article-title":"Efficacy of single-shot ultrasound-guided erector spinae plane block for postoperative analgesia after mastectomy:A randomized controlled study","volume":"14","author":"Seelam","year":"2020","journal-title":"Saudi J Anaesth"},{"key":"R15-20260520","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1186\/s42077-023-00339-1","article-title":"Comparative study between ultrasound-guided erector spinae plane block and thoracic paravertebral block for postoperative analgesia after video-assisted thoracic surgery:An equivalence study","volume":"15","author":"Sobhy","year":"2023","journal-title":"Ain-Shams J Anesthesiol"}],"container-title":["Indian Journal of 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History"}},{"value":"2026-04-28","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}