الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Breast Cancer is the most commonly occurring cancer affecting women, modified radical mastectomy is the gold standard treatment when feasible. But with numerous painful complications including acute pain, and in high percentage of patients, it progresses to chronic pain syndromes. PECS II and ESB blocks are novel options of regional anesthesia that can produce reliable analgesia without the potential risks of neuraxial block. This controlled study aimed to evaluate the analgesic efficacy of ultrasound guided PECS II block or ESB block in patients who underwent MRM surgery. This prospective randomized controlled study was carried out in Tanta University Hospital Anathesia Department after approval from ethical committee and informed consent signed by the enrolled patient describing benefits and hazards of the technique. The study included 60 adult female patients aged 21 -65 years, ASA class II&III scheduled for elective MRM surgery. Patients were allocated randomly into three groups: control group who received general anesthesia only, group II who received ESB block with general anathesia and group III who received PECS II block with general anesthesia. Total postoperative morphine consumption showed statistically significant decrease in group II and III compared to group I with group III with statistically significant decrease compared to group II. Time to first analgesic requirement showed statistically significant increase in group I compared to groups II and III Postoperative Numeric Rating Scale comparison between the three groups showed statistically significant decrease in NRS postoperatively in groups II and III compared to group I. Total intra-operative fentanyl consumption showed statistically significant decrease in groups II and III compared to group I. Regarding hemodynamic parameter, comparison between the three groups in intra-operative and post-operative MAP showed statistically significant difference between groups throughout intraoperative and postoperative durations ,MAP showed statistically significant decrease in groups II and III compared to group I while comparison between the three groups in intra-operative and post-operative HR showed statistically significant difference between groups throughout intraoperative and postoperative durations ,HR showed statistically significant decrease in groups II and III compared to group I. Concerning complications in our study, there was no complication recorded as regard intra-operative or post-operative complication ie no hypotention, bradycardia, hematoma or pneumothorax.