ultrasoundguided bilateral erector spinae block versus tumescent anesthesia for postoperative analgesia in patients undergoing reduction mammoplasty a randomized controlled study purpose the aim of this prospective randomized doubleblind study was to compare the tumescent anesthesia method and erector spinae block with respect to postoperative analgesia consumption pain scores and patient satisfaction in patients receiving breast reduction surgery under general anesthesiamethods the study included 44 females aged 2065 years who were to undergo breast reduction surgery without adjunctive liposuction on the breast using the closed envelope method the patients were randomly separated into two groups to receive tumescent anesthesia or erector spinae block esb patients in the esb group received the block before general anesthesia by a single anesthetist gresults the 24h tramadol consumption with pca which was the primary outcome of the study was determined to be statistically significantly less in the esb group p0001 the nrs scores were compared at 30 min postoperatively and then at 1 2 4 6 12 and 24 h at all the measured time points the pain scores of the esb group were statistically significantly lower p0001 additional analgesia was required by one patient in the esb group and by seven patients in the tumescent group and was applied as 1 g paracetamol the requirement for additional analgesia was statistically significantly lower in the esb group p0024 patient satisfaction was statistically significantly better in the esb group p0001conclusions according to the results of this study bilateral esb performed under ultrasound guidance in breast reduction surgery was more effective than tumescent anesthesia concerning postoperative analgesia consumption and pain scores esb could be an appropriate effective and safe postoperative analgesia method for patients undergoing reduction mammoplasty surgerylevel of evidence ii this journal requires that authors assign a level of evidence to each article for a full description of these evidencebased medicine ratings please refer to the table of contents or the online instructions to authors wwwspringercom00266