Comparison of 0.375% and 0.2% Ropivacaine for Postoperative Analgesia Using Ultrasound-Guided Pectoral Nerve Block in Patients Undergoing Breast Cancer Surgery: A Randomized Controlled Study

Introduction: Breast cancer incidence has been rising in recent years, particularly among younger women, and it is now the leading cancer among Indian females. Acute postoperative pain is a significant concern, often deterring patients from surgery. Combining regional anesthesia with intravenous analgesics can improve postoperative outcomes. This study compares two concentrations of ropivacaine for managing postoperative pain in breast cancer surgeries. Materials and Methods: Patients were randomized into two groups: Group 1 received 0.375% ropivacaine, and Group 2 received 0.2% ropivacaine via ultrasound-guided pectoral nerve block after anesthesia induction for breast surgeries. Baseline vitals were recorded. Intraoperative analgesia included fentanyl, IV paracetamol, and nerve block. Postoperative vitals and pain scores were monitored at regular intervals, with rescue analgesia provided through patient-controlled IV fentanyl. Statistical analysis used Chi-square or Fisher's exact tests for nominal categorical data and Mann-Whitney U or Wilcoxon Rank Sum tests for non-normal continuous variables. Results: Both groups were comparable in demographic data. Postoperative systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate (PR) measured at fixed intervals showed no significant differences between the groups. Pain scores on the numeric rating scale were also similar. While total 24-hour fentanyl consumption did not differ significantly, average fentanyl use was lower in Group 1. Conclusion: This study found no significant difference in postoperative pain, antiemetic requirements, or patient satisfaction between 0.375% and 0.2% ropivacaine. While 0.2% ropivacaine is equally effective in terms of analgesia and patient satisfaction, 0.375% may be preferred in scenarios requiring prolonged sensory blockade. While 0.2% ropivacaine is equally effective in terms of analgesia and patient satisfaction, 0.375% may be preferred in scenarios requiring prolonged sensory blockade.