الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
Abstract
SUMMARY
B
reast cancer has continued to be the most common cancer afflicting women, accounting for 31% of all new cancer cases in the female population. Every year, thousands of patients undergo surgery in the region of the breast and axilla. Surgery is one of the mainstays of treatment, and a procedure called modified radical mastectomy (MRM) is now a standard surgical treatment for early-stage breast cancers.
However, Traditional opioid-based analgesia remains the mainstay, different techniques including regional local anaesthetic infiltrations, paravertebral and neuraxial analgesia, anticonvulsants, anti-neuropathic analgesics and NMDA antagonists have all been used either in isolation or in combination.
After the application of ultrasound in anesthetic practice, several interfascial plane blocks have been described recently. Pec 1 block involves a hydro dissection of the plane between the pectoral muscles with local anaesthetic to block the lateral and medial pectoral nerves. Serratus anterior plane blocks performed at the axillary fossa, the intercostobrachialis nerve, lateral cutaneous branches of the intercostal nerves (T3–T9), long thoracic nerve, and thoracodorsal nerve are located in a compartment between the serratus anterior and the latissimus dorsi muscles, between the posterior and midaxillary lines. Those are newer US-guided blocks for analgesia after breast and lateral thoracic wall surgery. The key sonographic landmarks are the pectoralis major, pectoralis minor, and serratus anterior muscles and the pectoral branch of the acromiothoracic artery.
The aim of this work is to evaluate The Effectiveness of Ultrasound Guided Pectoral nerve block (PEC1) versus Serratus Anterior plane block (SAPB) for postoperative Analgesia in Modified Radical Mastectomy
After obtaining approval from the medical ethical committee in Ain Shams University This study was conducted in the operating theatres of Ain Shams University Hospitals. It included Thirty Female patients undergoing Modified Radical Mastectomy were divided randomly into two groups, each group consisted of 15 patients group I in which patients received PEC 1 and group II in which patients received Serratus Anterior Plane Block (SAPB).
The two groups were adequately monitored and assessed post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system, besides, recording time for first for analgesic need and total consumption of opioid and analgesic in the 1st 24 postoperative hours. Demographic data and post operative hemodynamics were also assessed