Comparative Study between Ultrasound Guided Modified Pectoral Nerve Block (PECSΙΙ) versus Ultrasound Guided Serratus Anterior Muscle Plane Block for Analgesia Following Modified Radical Mastectomy

Abstract

Abstract Background Modified pectoral nerve (PECSII) and serratus plane blocks have been recently used for analgesia in breast surgery, but evidence comparing their analgesic benefits is limited. This comparative study aims to examine the analgesic efficacy and safety profile of ultrasound-guided PECSII versus serratus block in patients undergoing modified radical mastectomy (MRM) for breast cancer. Objective To evaluate and compare the effect of both PECS II block versus and Serratus anterior block in patients undergoing modified radical mastectomy surgery. Patients and Methods The duration of analgesia and effect on hemodynamics parameters were evaluated. Moreover, undesirable side effects were studied. Thirty-six patients were randomly allocated into two equal groups (18 patients): group (A) and group (B). Group (A): received a PECSII block with 30 mL of bupivacaine 0.25%. Group (B): received a serratus anterior plane block (SAPB) using the same volume of 30 ml bupivacaine 0.25%. All patients were clinically assessed and routine preoperative investigations were done: CBC, Coagulation profile, liver function tests, kidney function tests, fasting blood sugar and ECG. The initial vital data were measured after applying the standard monitoring including pulse oximetry, non-invasive blood pressure and ECG. Results This study demonstrated that PECSII and serratus blocks have comparable analgesic properties in patients undergoing modified radical mastectomy. Both blocks were comparable in postoperative pain intensity, postoperative morphine consumption, and intraoperative fentanyl requirement. The two blocks were comparable in hemodynamics, and VAS score. The two blocks were associated with hemodynamic stability, and high satisfaction scores. The absence of major complications characterizes both blocks. Conclusion This study confirms that PECSII and serratus blocks provide similar adequate analgesia following modified radical mastectomy.