Opioid free anaesthesia with Pecs and Pecto-Intercostal fascial plane blocks versus opioid based general anaesthesia in breast cancer surgeries

Breast cancer surgeries are generally done using strong opioids. However, these drugs carry disadvantages such as postoperative nausea and vomiting, respiratory depression, suppression of immune and gastrointestinal function, which hinder rapid recovery of patients in the early postoperative period. Our objective is to study the immediate patient outcomes using opioid free anaesthesia (OFA) with block and Dexmedetomidine, Ketamine and Magnesium vs conventional opioid based anaesthesia (OBA). OFA group will receive premedication with dexmedetomidine 0.5 mg/kg and MgSO4 20 mg/kg in 100 ml NS over 10 mins intravenously. After induction patients will be given infusion of dexmedetomidine (1 mcg/ml) with ketamine (1 mg/ml) at 1 ml/10 kg/hr. They will also receive PECS-Pectointercostal Fascial Plane block before the start of surgery. Conventional OBA group will receive fentanyl at 2 mcg/kg during induction. Both groups will be induced General Anaesthesia with propofol and vecuronium. Anaesthesia will be maintened with sevoflurane at MAC of 0.8-1.2 in oxygen air mixture. Intra operatively paracetamol and dexamethasone will be given and at the end of surgery reversal will be done with neostigmine and glycopyrrolate.