To study the efficiacy of serratus posterior superior block in controlling perioperative breast cancer surgery pain and its effect on inflamatory markers.

Back ground The presence of pain during the initial course of treatment in women with early-stage breast cancer was associated with significantly higher levels of c-reactive protein(CRP) ,interleukin-7(IL-7)and interleukin-13(IL-13) There is evidence of effectiveness of regional block in controlling inflamatory markers Serratus posterior superior intercostal plane block (SPSIPB) is a novel Regional technique that provides analgesia in the hemithorax, shoulder, and back of the neck which proved its efficacy in controlling pain after Video assisted thoracoscopic surgery there are little epidemiological data on (SPSIPB)usage in masectomy and lumpectomy procedures and its effect on inflamatory markers

Methodology:

• Type of the Study: Randomized prospective comparative controlled double-blinded study

  • Study Setting: Ain Shams University Hospitals
  • Study Period: One year after approval of the protocol.
  • Place :Ain shams university hospitals
  • Study Population: Adult patients who will undergo breast cancer surgey.

Inclusion Criteria:

• Adults undergoing unilateral breast surgery under general anesthesia
• Age 21 to 60 years with body mass index (BMI)=18 to 25 kg/m2
• American Society of Anesthesiologists (ASA) grade I-III.

Exclusion Criteria:

• Patients with Long-time use of analgesic drugs
• Past history of chest surgery,
• Allergy to local anesthetics,
• Systemic infection,
• Cognitive and language disorders precluding participation,
• Patients with coagulopathy,anticoagulant users
• hemodynamic unstable patients
• Patients with neurology, spinal, psychiatry diseases
• infection at block site
• patients refused to participate in the study .