Ultrasound-guided erector spinae block versus serratus anterior block for perioperative analgesia in patients undergoing modified radical mastectomy surgery

Background Breast cancer is the most prevalent cancer among women. There are several approaches to postmastectomy pain management such as opioids, nonsteroid anti-inflammatory which have many side effects. on the other hand, uses of regional block more effective and less side effect, prior research has demonstrated that erector spinae block (ESB) effectively reduces postoperative pain. Aim Assess and compare between ultrasound-guided ESB and Serratus anterior Block (SAB) for peri operative analgesia in patients undergoing Modified Radical Mastectomy (MRM) under general anesthesia. Patients and methods A total of 75 female patients scheduled for MRM were randomized to three equal groups: (group C) patient received no block, (group E) patient received ESB and (group S) patient received serratus anterior block before induction of anesthesia. The primary outcome was the time of the first rescue analgesic, The secondary outcomes were total consumption of opioid perioperative, visual analogue scale (VAS) in static and dynamic state, onset and duration of sensory block and complication. Results In the current study, there was a significant delay in the first time of rescue analgesia and a lower total dose of rescue analgesia in erectors when compared with the other two groups ( P <0.001). Furthermore, there was a significant delay of the first time of rescue analgesia and a lower total dose of rescue analgesia in the serratus group when compared with control group ( P <0.001). Conclusion Ultrasound-guided ESB and SPB are simple and safe techniques for the management of postoperative pain in patients underwent MRM. ESB technique provided significant superior analgesia and longer time for the first required analgesic than SPB technique.