Analgesic efficacy of ultrasound-guided PECS II and transeversus thoracic plane blocks compared to serratus anterior plane block for modified radical mastectomy: A randomized prospective study

Figures & data

Figure 1. PECS II block -TTP block.

A) anatomy of First injection. B) local anesthetic injection between PM and Pm. C) Anatomy of second injection D) Local anesthetic injection between Pm and SA E) TTP anatomy. F) local anesthetic injection between TTM and internal intercostal muscles, SA (serratus anterior muscle), PM (pectoralis major muscle), Pm (pectoralis minor muscle), TTM (transeversus thoracic muscle), LA (local anesthetic).

Figure 2. SAP block.

A) Anatomy of SAP; LD, SAM. B) Local anesthetic between latissimus dorsi and serratus anterior muscles, LD (latissimus dorsi muscle), SAM (serratus anterior muscle), LA (local anesthetic).

Figure 3. Participant flow diagram.

Table 1. Patient’s characteristic in the two groups.

	Group I (n = 35)	Group II (n = 35)	95% CI	P
Age (years)	48 ± 6	50 ± 6.2	−4.84, 0.78	0.154
BMI (kg/m^2)	27.80 ± 2.80	29.05 ± 3.59	−2.79, 0.28	0.109
Duration of surgery (minutes)	111 ± 16.14	105 ± 15	−1.41, 13.41	0.111

Abbreviations: ASA American Society of Anesthesiologists, BNI: body mass index Data presented as mean ± SD or number (n)%. Significant at p < 0.05

Figure 4. VAS score changes in the two groups.

Table 2. Dose of postoperative morphine (mg), intraoperative fentanyl (µg), patient satisfaction and complications in the two groups.

		Group I (n = 35)	Group II (n = 35)	95% CI	P
Total dose of morphine in the first 24 hours (mg)		3 (3, 6) *	9 (9, 12)	−6.0, − 3.4	<0.001*
Time of first request of analgesia (hours)		8 (6, 12) *	6 (4, 8)	0.27, 3.96	0.026*
Patients needed intraoperative fentanyl (n)%		3 (8.6%)	5 (14.3%)		0.452
Patient satisfaction	Satisfied (n)%	33 (94.3%)	31 (88.6%)		0.673
	Fair (n)%	2 (5.7%)	4 (11.4%)
	Unsatisfied (n)%	0	0
Nausea and vomiting (n)%		9 (25.7%)	5 (14.3%)		0.232

- Data presented as median (IQR) or number (%).

*Significant at p < 0.05.