الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Postoperative pain is a significant concern following modified radical mastectomy (MRM) surgery. Unfortunately, previous studies have reported that acute postoperative pain is highly associated with development of chronic pain. Therefore, many different kinds of analgesic techniques have been proposed, erector spinae plane block (ESPB) and rhomboid intercostal block (RIB) to relieve acute postoperative pain. Rhomboid intercostal block (RIB) was first described in 2016 by El Sharkawy. Following the injection of local anesthetic into the interfacial plane between rhomboid major and intercostal muscles, the block provides analgesia for both the anterior and posterior hemithorax. The aim of this study was to compare and evaluate the efficiency of ultrasound-guided rhomboid intercostal block versus erector spinae plane block in reducing the postoperative pain after a modified radical mastectomy. The current study was a double-blinded comparative study which included 100 patients whom passed inclusion criteria, scheduled for modified radical mastectomy under GA. The study was carried out at the Oncology Center, Mansoura University (OCMU) for 12 months from October 2021 to October 2022. Patients were randomly assigned into 2 equal groups each of 50 patients. RIB group included patients who received ultrasound-guided Rhomboids intercostal block. And ESPB group included patients who received ultrasound-guided Erector spinae plane block. Data collected include the thoracic dermatome blocked, the total analgesic requirements during the first 24 hours Postoperative, the duration of effective analgesia (VAS<30), postoperative visual analog score (VAS) at 0, 2, 4, 6, 8, 10, 12, 16, 20, and 24 hours postoperatively, intraoperative and postoperative hemodynamics, perioperative complications and incidence of chronic pain at 1month and 3 months. In this study, we found that both ESPB and RIB are effective techniques for reducing postoperative pain for patients undergoing MRM. In addition, we found that ESPB and RIB are both safe techniques regarding side effects and hemodynamics. However, the ESPB group showed a wider extent of blocked dermatomes, a lower VAS score, and less fentanyl consumption.