Opioid-free mastectomy in combination with ultrasound-guided erector spinae block: A series of five cases

Persistent pain after breast surgery for cancer is observed in more than 60% patients.[1] Although opioids have been mainstay for managing postoperative pain, they have undesirable side effects such as constipation, sedation, respiratory depression, urinary retention, postoperative nausea and vomiting, and pruritus. Opioid-induced hyperalgesia or opioid paradox has been described as increased perception of pain after opioid-based anaesthesia and surgery.[2] We used opioid-free general anaesthesia (OFGA) technique in five patients who underwent modified radical mastectomy along with a preoperative ultrasound (US)-guided erector spinae plane (ESP) block under local anaesthesia.