COMPARING THE EFFICACY OF ULTRASOUND-GUIDED PECTORAL NERVE BLOCK VERSUS THORACIC EPIDURAL BLOCK USING ROPIVACAINE FOR POSTOPERATIVE ANALGESIA AFTER MODIFIED RADICAL MASTECTOMY A RANDOMISED CONTROLLED TRIAL

To compare the better analgesic efficacy of two groups i.e., ropivacaine (0.2%) for post operative pain relief in patient undergoing modified radical mastectomy (Ultrasound guided pectoral nerve block vs thoracic epidural block)

In this study, two groups

T group(thoracic epidural block) patient were received a single shot of 15ml of 0.2% ropivacaine between t4 and t5 vertebrae.

PECS(p group)The pectoral nerve (PecS II) block, which was first described by Blanco et al.,is a relatively new, less-invasive technique of postoperative analgesia and is devoid of major side effects. The Pecs II block is an interfascial plane block, where Ropivacaine 0.2%-10ml is deposited into the plane between the pectoralis major muscle (PMm) and the pectoralis minor muscle (Pmm) (PecS I block) and Ropivacaine 0.2%-15ml is injected between Pmm and the serratus anterior muscle at the third rib (Pecs II block). This novel technique also blocks long thoracic and thoracodorsal nerves, lateral and medial pectoral nerves along with lateral branches of intercostal nerves, exiting at the level of mid-axillary line to innervate the breast and the skin innervate from T2 to T6, thus providing good analgesia for mastectomy and axillary clearance.

Assessment of post operative pain in both groups will be done using VAS (Visual Analogue Scale) score 1-10 at 30min, 4hrs, 8hrs,12 hrs,20 hrs and 24hrs after surgery and the data will be recorded in both groups.

If a VAS score of 4 is reported rescue analgesia will be given at that time using Inj.Tramadol 50mg iv and the frequency of the rescue analgesics will also be noted for both the groups. Side effects of ropivacaine-nausea and vomiting.