الفهرس 
Anatomy of The Thoracic Wall and BreastOnly 14 pages are availabe for public view
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Abstract
Background: Poorly controlled acute pain after breast surgery is associated with a variety of unwanted post-operative consequences, including patient suffering, distress, respiratory complications, prolonged hospital stay and an increased likelihood of chronic pain. The analgesic regimen used for postoperative pain control needs to meet the goals of providing safe, effective analgesia, with minimal side effects for the patient.
Objective: to compare the intra-operative and the post-operative analgesic effects of the thoracic interfascial plane blocks (serratus anterior plane block in combination with pecto-intercostal fascial plane block) and pectoral nerve blocks (PECS I and II )in patients undergoing non-reconstructive breast surgeries.
Patients and Methods: The study was conducted on 50 randomly chosen patients in Ain Shams University General Surgery Hospital after approval of the medical ethical committee. They were allocated in two groups of 25 patients each. The two groups were adequately monitored and assessed intra-operatively and post-operatively and they were compared regarding analgesic outcome by using the visual analogue scaling system in the first 24 hours postoperative and the patients’ satisfaction using verbal rating scale and this was the primary outcome of our study, also the amount of fentanyl consumed intra-operative, time for first call for rescue analgesia and the frequency of using it were recorded and compared to achieve our secondary outcome of the study which included reducing opiods requirements and avoiding their side effects.
Results: The results of our study were in pro of the combination of pectoral nerve blocks (PECS I and II ), as we have found that the total amount of intra-operative fentanyl consumption was significantly higher in the SAPB and PIFB than the Pecs group, and the VAS was significantly higher in the combination of serratus anterior plane block and pecto-intercostal fascial plane block compared to Pecs I and II, also the number of patients who received post-operative morphine were significantly increase in SAPB and PIFB, the first request of post-operative morphine was significantly delayed in the pectoral nerve blocks than the SABP and PIFB group.
Conclusion: The present study found that Pecs I and II group provided superior intra-operative and post-operative analgesic control compared to the serratus and PIFB group in patients undergoing non-reconstructive breast surgeries.