Background: One of the most frequently performed breast surgeries is the modified radical mastectomy (MRM). Following breast surgery, patients report significant acute pain. Regional anesthesia utilization shows potential in relieving discomfort following breast surgeries.
Objective: To evaluate safety and effectiveness of ultrasound-guided erector spinae plane block (ESPB)and pectoral plane block (PECS) on the quality of analgesia postoperatively for postoperative pain relief in patients undergoing MRM.
Patients and Methods: This randomized, clinical trial included 90 women aged from 18 to 65 years undergoing MRM. Patients were randomly allocated into two equal groups: Group I received an ultrasound-guided ESPB, while Group II received an ultrasound-guided PECS block. All patients were subjected to clinical assessment, and laboratory investigation. Patients were administered one tablet of alprazolam 0.5 mg two hours prior to the scheduled surgery on the day of the operation.
Results: Visual analogue scale (VAS) at rest and at movement were significantly lower at 6, 12 and 24 h in group II compared to group I (P<0.05). Time of 1st rescue analgesic requirement was significantly delayed in group II compared to group I (P=0.003). In comparison to group I, the overall dose of morphine and the number of patients who required rescue analgesia were significantly lower in group II (P=0.017, 0.039 respectively).
Conclusions: In patients underwent MRM, PECS block showed superior pain relief, less postoperative analgesic requirement with delayed request and lower morphine consumption. However adverse events were less common in both modalities, PONV incidence was less in PECS than ESPB.