Mid point transverse process to pleura block versus thoracic paravertebral block for post operative analgesia in patients undergoing Modified radical mastectomy-a randomized controlled non inferiority study (Academic trial)

Most patients undergoing breast surgery complain of acute postoperative pain in the chest, arm, and axilla. If untreated, this leads to chronic pain and restriction of shoulder movements, thus decreasing the quality of life of breast cancer survivors. Preventive analgesia through multimodal approaches ensures control of continuous neuronal firing, which eventually decreases the incidence of chronic pain, morbidity, and mortality. Among the various regional anesthesia techniques used for postoperative analgesia in the) modified radical mastectomy (MRM), thoracic paravertebral block (TPVB) is presently considered the technique of choice. Recently, a newer technique, “midpoint transverse process to pleura” (MTP) block has been described in which the tip of the needle is placed at the midpoint between the transverse process and pleura. MTP block is a novel technique that has been hypothesized to be a safe alternative that achieves paravertebral block with an injection between the midpoint of the posterior transverse process and pleura.