We aim to study the effect of adding magnesium sulfate as an adjuvant to the local anesthetic used in the combined Pectoralis Nerve Block II (PECS II) and stellate ganglion block for postoperative pain control in patients undergoing modified radical mastectomy.

Post-operative pain from breast surgery can be controlled by regular pain medications such as paracetamol, non-steroidal anti-inflammatory (NSAIDs), and narcotics. Nerve blocks are commonly used as multimodal approaches for acute post-operative pain relief.

Pectoral and stellate ganglion blocks are regional anesthesia techniques that target the thoracic nerves and sympathetic nerve ganglia to provide analgesia for the upper extremity and chest regions. When combined, these blocks have shown promising results in alleviating perioperative pain for patients undergoing modified radical mastectomy.

Magnesium sulfate, a well-known adjuvant, has been studied extensively for its analgesic properties and anti-inflammatory effects.

Inclusion Criteria:

• Age ≥18 years.
• Female gender.
• American Society of Anesthesiologists (ASA) physical status II or III.
• Patients scheduled for elective modified radical mastectomy for breast cancer.
• Body mass index (BMI): > 20 kg/m2 and < 40 kg/m2.

Exclusion Criteria:

• Bleeding tendency due to coagulopathy,
• Patients with opioid dependence or alcohol or drug abuse,
• Significant liver and renal sufficiency
• Patients with psychiatric illnesses that prevent them from proper perception and assessment of pain.
• Local infection at the site of the block.
• Known hypersensitivity or allergy to magnesium sulfate or local anesthetics.
• Patients with chronic pain syndromes or pre-existing neuropathic pain conditions.
• Pregnant or lactating individuals.

The data will be available upon a reasonable request from the corresponding author after the end of study for one year.

After the end of the study for one year.

The data will be available upon a reasonable request from the corresponding author.