الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
Treatment for breast cancer consists primarily of surgery (partial or complete mastectomy). Nearly 60% of breast surgery patients experience severe acute postoperative pain, with incidence rates increasing with surgical complexity. Postmastectomy pain syndrome is a recognized comorbidity of cancer breast surgeries. 52% women who underwent breast cancer surgery are reported to develop chronic pain in the postoperative period with significantly lower quality of life. Acute clinically significant postoperative pain is independent predictor to develop more intense chronic pain 3 months after surgery.
Many regional anesthesia techniques are being used to control perioperative pain in cancer breast surgeries as thoracic paravertebral block and modified pectoral nerve block. The newer erector spinae plane block which was first described or chronic pain management, has been used since for perioperative pain management in various types of surgeries including cancer breast surgeries.
The aim of the study is to compare between the effects of ultrasound guided thoracic paravertebral block, pectoral nerve block II, and erector spinae block in management of pain during cancer breast surgeries. The hypothesis of the study is that the three groups will give comparative results.
This study included 80 female patients between 18-60 years old, ASA I/II underwent elective modified radical mastectomies (MRM). Patients were randomized equally to four groups (n=20). Each group either received one under study regional anesthesia block, or received only intravenous morphine for pain management in control group.
The primary outcome of the study was duration of analgesia defined by the time of the first rescue analgesia after administration of the block). Also the study compared VAS score of postoperative pain, morphine consumption, any adverse complications of any block, postoperative nausea/vomiting and intraoperative hemodynamics were recorded as well.
The erector spinae block is more effective in reducing pain scores and intravenous morphine consumption compared with no block in adults undergoing cancer breast surgeries.
The erector spinae block has equal both duration of analgesia and reduction in total morphine consumption with thoracic paravertebral block.
The erector spinae block has shorter duration of analgesia than pectoral nerve block. The pectoral block is more effective in reducing morphine consumption than erector spinae block.
The erector spina block is effective in reducing postoperative pain and morphine consumption in adults undergoing cancer breast surgeries. Although, pectoral nerve block is more superior to erector spinae block, the erector spina is an effective alternative to conventional regional anesthesia techniques.