Ultrasound Guided Modified Pectoral Plane Block Versus Erector Spinae Plane Block During GA in Gynecomastia Surgery

Ultrasound Guided Modified Pectoral Plane (PECS II )Block Versus Erector Spinae Plane (ESP) Block for Perioperative Analgesia of Surgical Treatment of Gynecomastia

Pain of breast surgery is due to chest wall scar and arm in some cases like carcinoma or due to nerve injury.It is neuropathic or nociceptive pain.Its severity is depending on the extent of surgery and the radiotherapy if needed.

Previous studies proved that local nerve block procedures improved the immediate postoperative pain and decreased the incidence of postoperative pain chronicity .

Also effective control of pain suppresses the surgical stress response minimizes the anaesthestic needs intraoperatively and decreases the opioid needs postoperatively .

Pectoralis nerve(pecs) II block and erector spinae plane (ESP) block are novel procedures that may provide good intraoperative and postoperative analgesia in patients undergoing surgical treatment of gynecomastia.

Inclusion Criteria:

• Male gender .
• Age : 18 - 25 years old .
• Physical status : ASA I - II .
• Body mass index(BMI) :20-30 kg/m2
• Surgical treatment of Gynecomastia .
• Duration of surgery : 60 -120 min

Exclusion Criteria:

• Patient refusal .
• History of opioid abuse or chronic analgesic use .
• Coagulopathy .
• Allergy to study drugs .
• Infection in the injection sites.
• Uncooperative patients.