Ultrasound Guided Pecs Block and Ketamine Infusion for Preventing Chronic Pain in Patients Undergoing Breast Cancer Surgery

Effect of Ultrasound Guided Pecs Block With Intravenous Ketamine and Ketamine Infusion Alone For Prevention of Chronic Post-Surgical Pain in Patients Undergoing Breast Cancer Surgery: A Randomized Controlled Trial

The goal of this clinical trial is to is to compare the effectiveness of ultrasound-guided Pecs block with intravenous ketamine versus intravenous ketamine infusion alone in preventing Chronic Post-Surgical Pain (CPSP) in patients undergoing breast cancer surgery. The main question it aims to answer is,

How effective is the ketamine and ketamine with pecs block in reducing the frequency of Chronic Post-Surgical Pain after breast cancer surgery

Inclusion Criteria:

• Adult female patients with breast cancer aged between 18-75 years
• ASA (American Society of Anesthesia) physical status I, II, and III
• Patients scheduled for elective breast cancer surgery (Mastectomy with or without axillary clearance)

Exclusion Criteria:

• Refusal to participate or withdrawal of informed consent
• Surgical procedures involving breast reconstruction with flaps or implants
• Patient scheduled for bilateral mastectomy
• Reoperation on the same side due to cancer recurrence
• Known allergy or contraindication to study drugs
• History of severe psychiatric illness (e.g., major depression, bipolar disorder, schizophrenia)
• Chronic opioid use, substance abuse, or opioid addiction
• Pre-existing chronic pain or neuropathic pain disorders
• Coagulopathy, anticoagulation therapy, or localized infection at the site of block
• Uncontrolled hypertension and ischemic heart disease