Ultrasound guided modified pectoral nerve block associated with serratus anterior plane block Group compared to Erector Spinae Plane Block for post operative pain management in breast Surgeries

Abdel Hamid, Randa Attya; Saad, Saad Ibrahim; Afifi, Ehab Al-Shahat; Hafez, Sherif Kamal; Fekry Khedr, Amany Nagah

doi:10.21608/bmfj.2025.337700.2259

Ultrasound guided modified pectoral nerve block associated with serratus anterior plane block Group compared to Erector Spinae Plane Block for post operative pain management in breast Surgeries

Document Type : Original Article

Authors

¹ department of Anesthesiology and Surgical Intensive Care Faculty of Medicine - Benha University

² Professor of Anesthesia and Surgical Intensive Care Faculty of Medicine - Benha University

³ Assistant Professor of Anesthesia and Surgical Intensive Care Faculty of Medicine - kafr ElSheikh University

⁴ Lecturer of anesthesia and surgical intensive care Faculty of Medicine - Benha University

10.21608/bmfj.2025.337700.2259

Abstract

Background: Approximately 60% of women after breast cancer surgery complain of severe acute pain. In addition, failure to manage acute post-operative pain may lead to the development of chronic pain which may be persistent for years. Efficacious techniques such as Modified PECS with Serratus Anterior plane Block and Erector Spinae Plane Block proved to reduce post-operative pain and prevent unnecessary patient discomfort. It may play role in decreasing morbidity, post-operative hospital stay and thus cost. This study aimed to: compare the analgesic effectiveness of modified pectoral nerve block with serratus anterior plane block versus Erector spinae plane block in post-operative breast Surgeries pain management. Methods: This randomized controlled trial was conducted at Benha University on 60 female patients scheduled for breast surgeries. All patients were randomly assigned into three groups; control group (I) (perioperative conventional pain management), PECS group (II)(modified pectoral nerve block with serratus anterior plane block), and ESPB group(III) ( erector spinae plane block). Results: VAS was significantly lower in group II & group III compared to group l (p < 0.05), with no significant difference between group II & group III. The number of patients required morphine was significantly different among the studied groups, (P=0.016), being lower in group II compared to other groups. Conclusion: both the modified pectoral nerve block with serratus anterior plane block and erector spinae plane block significantly improve postoperative pain management and reduce opioid use in breast surgery patients compared to general anesthesia alone.

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