Effectiveness of Ultrasound-Guided Erector Spinae Plane Block vs. Modified Pectoral Nerves Block for Postoperative Pain in Modified Radical Mastectomy

Background: Globally, breast cancer is the most prevalent malignancy amongst females. The principal symptom of a syndrome denoting the presence of pain in and around the site of mastectomy for a duration exceeding three months after the procedure is chronic post-mastectomy pain (PMP) Aim and objectives: To compare Erector Spinae Plane Block modified pectoral nerves block following modified radical mastectomy regarding postoperative pain relief. Subjects and methods: This prospective, randomized, masked clinical trial was performed at Al-Azhar University Hospitals for Boys in Cairo. This research was performed on (60) individuals subjected to 2 groups: Group A: Erector Spinae Plane Block group (ESPB): (30) cases underwent ESP block after injection of general anesthesia. Group B:(Modified Pectoral Nerves Block (MPNP)): (30) cases underwent modified pectoral nerve block after induction of general anesthesia. Results: There was no statistically significant variance among the examined groups concerning age, BMI, duration of surgery, ASA status, heart rate before and after procedure, complications, while a statistically significant variance amongst the examined groups concerning after-surgery VAS score at 6, 12, 18, 24 hours, duration of Analgesia, duration of block, morphine consumption dose and satisfaction. Conclusion: We concluded that the PECS block was more effective in terms of reduced morphine consumption and lower pain scores in the first day postoperative period, in contrast to the ESP block in cases undergoing modified radical mastectomy surgeries.