Comparative evaluation of ultrasound guided PECS block of the two concentration of levobupivacaine with adjuvant dexmedetomidine in patients undergoing modified radical mastectomy

Breast cancer is the most common cancer in the women worldwide. Mastectomy is the treatment of choice for carcinoma breast stage-I and -II with tumours not involving the chest-muscle fascia. Modified radical mastectomy (MRM) involves removal of the whole breast which includes the skin, areola, nipple, and most axillary lymph nodes. During mastectomy, some of the nerves in the chest are severed. Most women have some level of pain after the procedure. Severe acute postoperative pain following breast surgery not only increases the risk of persistent pain and affects recovery, it also leads to longer hospitalization and increased healthcare costs. Pectoral nerve block can provide a good analgesic effect for pain after carcinoma breast surgery. PECS blocks have also been proposed as alternative techniques to anesthetize operative regions such as the axilla, proximal medial upper arm, and posterior shoulder. In our study we are planning to give PECS block before induction of general anesthesia in two different concentration of levobupivacaine with adjuvant (dexmedetomidine).We will look which concentration of levobupivacaine with adjuvant (dexmedetomidine) will be better for postoperative analgesia .