Comparison of Postoperative Analgesic Effect of Ultrasound Guided Pectoral vs Erector Spinae Block in Patients Undergoing Modified Radical Mastectomy

Background: Modied radical mastectomy (MRM) for breast cancer treatment causes signicant post-operative patient discomfort. Regional anesthetic techniques are the key to effective analgesia in postoperative period. The development of ultrasound-guided regional anesthesia including erector spinae plane (ESP) block and pectoralis (PECS) block are some novel techniques. Aim: This study aimed to compare the analgesic efcacy of USG guided erector spinae plane (ESP) block and pectoral nerve (PECS) block. Materials and Method: This study was a randomized controlled trial comprising 60 patients over the age of 18, scheduled for elective breast cancer surgery and were classied as American Society of Anesthesiologists (ASA) I–III. Group Areceived USG-guided Erector Spinae plane block and Group B received USG-guided Pectoral Nerve block containing 30 mLof 0.25% bupivacaine each. Visual analogue scale (VAS) readings, nausea, vomiting and analgesic requirements by each patient throughout the postoperative phase were documented. Results were analysed using SPSS 20.0 version and data in groups were compared with chi-square and sher's exact tests. Results: Opioid requirements during intra and post-operative period were statistically reduced in PECS group compared to ESP group. The PECS group had a statistically signicant decrease in the number of patients requiring rescue opioid during the post-operative period (p <0.001) and also a longer time to rst analgesic requirement (p<0.001). These groups showed no variations in complications or postoperative nausea and vomiting. PECS block group had a statistically signicant reduced on-movement VAS score during the rst 4-hour post-operative period compared to ESP block group (p values 0.006, 0.031, 0.019, and 0.004, respectively). Conclusion: The study found that, as compared to ESP block, ultrasound guided PECS block produced more successful postoperative analgesia in patients undergoing breast cancer surgery along with measurable benet with regard to opioid requirement.