ultrasound guided paravertebral, pectoralis II and serratus anterior plane block in breast surgeries: spread of local anesthetic and post operative analgesia

Breast surgeries are associated with significant post operative pain which may progress to chronic pain. Regional techniques reduce the postoperative acute pain which results in reduced morbidity and decreased consumption of opioids. Paravertebral block is commonly used for breast surgeries. However it is associated with many complications.

Two new ultrasound guided interfascial plane blocks-PECS II and serratus plane block have been recently described which are more selective, have less complications and may provide better analgesia.

There are no studies comparing these blocks for breast surgery. Also, evaluating the area of sensory blockade in large number of patients will help in describing the extent of blockade more accurately and their use may extend beyond breast surgeries. This study is designed to study about these new techniques under ultrasound guidance to ensure maximum safety and find their analgesic efficacy.

Therefore, we hypothesize that

·         PECS II and serratus plane block will provide better analgesia than paravertebral block for breast surgeries with lesser side effects.

·         Serratus plane block will provide better sensory blockade and analgesia than PECS II block.