Ultrasound Guided Pectoral Nerve Block (PEC I) versus Serratus Anterior Plane block (SAPB) for Postoperative Analgesia in Modified Radical Mastectomy

Abstract

reast cancer is the most common cancer in women both in the developed and less developed world. In 2012, it represented about 12 percent of all new cancer cases and 25 percent of all cancers in women. A procedure called Modified radical mastectomy is now a standard surgical treatment for early stage breast cancers. These procedures cause significant acute pain and may progress to chronic pain states in 25–60% of cases. Though various risk factors have been suggested, inappropriate acute postoperative pain management has been associated with the development of chronic post-mastectomy pain, a complex post-surgical pain syndrome that may occur following any type of breast surgery. After the application of ultrasound in anesthetic practice, several interfascial plane blocks have been described. Pec I block involves a hydrodissection of the plane between the pectoral muscles with local anesthetic to block the lateral and medial pectoral nerves, serratus anterior plane blocks performed at the axillary fossa, in which 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