Effects of erector spinae block on the postoperative quality of recovery after gender reassignment chest surgeries: A prospective randomized double-blinded study

ABSTRACT Background: Erector spinae plane block (ESPB) improves postoperative analgesia and significantly enhances the quality of recovery (QoR) after thoracic and breast surgeries. However, it is not known whether this block is beneficial in chest reassignment surgery in transgender patients. Regarding sexual reassignment surgeries, there is no data on appropriate and safe postoperative analgesia, especially in chest surgeries. ESPB may be an important part of postoperative analgesia application in such surgeries. Objectives: The objective is to determine whether ESPB could provide effective postoperative pain control in chest reassignment surgeries. The primary objective is to check for effective pain control in the postoperative period using pain scores. The secondary objective is to evaluate the effectiveness of ultrasound-guided ESPB on postoperative QoR using recovery and sedation scores. Methods: A randomized prospective double-blinded study was conducted at a tertiary university hospital. Eighty-two patients scheduled for elective chest reassignment surgeries were included in the study. Patients were randomized into the ESP group or the control group. The quality of recovery after surgery was measured using the 40-item quality of recovery (QoR-40). Numerical rating scale (NRS) scores at rest and then at coughing, analgesic requirements, and occurrences of nausea and vomiting were recorded. Results: Intraoperative and postoperative opioid consumption, rescue analgesia requirement, and resting and dynamic NRS scores were significantly lower in the ESP group ( P < 0.05). There was no significant difference between the two groups in terms of the presence of dynamic pain after the first postoperative hour. While all patients in the control group had nausea and vomiting, 24% of the patients in the ESP group did not have nausea and vomiting. Conclusion: This study showed that ESPB can be used as a sole analgesic agent, with the benefit of reducing opioid consumption and postoperative nausea and vomiting in sexual reassignment surgery in the chest.