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

Medicine (Baltimore). 2025 Sep 12;104(37):e44466. doi: 10.1097/MD.0000000000044466.

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.

PMID:40958235 | DOI:10.1097/MD.0000000000044466