الفهرس 
Effect of adding magnesium sulphate versus ketamine to bupivacaine using ultrasound guided thoracic paravertebral block on perioperative analgesia in patient undergoing modified radical mastectomy
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Abstract
Breast cancer is the most common cancer in women.It represents about (38.8%) of all types of cancer affecting female in Egypt.Postoperative pain is one of the greatest patient concerns following any surgery.Patients undergoing breast surgery require a multimodal postoperative pain treatment regimen that provides high quality analgesia with minimal side effects. Until now, oncologic breast surgeries are typically performed by general anesthesia (GA). However, GA cannot provide adequate postoperative pain control and routine use of parenteral opioids aggravate postoperative sedation, nausea, emesis, impaired oxygenation and depressed ventilation. Many studies have been carried out trying to find a solution for these dilemma thus different analgesic modalities as local infiltration of the surgical field, systemic analgesia, neuro-axial blocks, and nerve blocks