الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 89 |  |  |
| | | from | 89 | | |
Abstract
Breast cancer is the most diagnosed cancer worldwide, and it is also the fifth leading cause of death. Most patients undergo surgery to eradicate and treating these malignancies.
postoperative pain after mastectomy is a mix of nociceptive and neuropathic pain that, if not handled appropriately, can progress to chronic pain, and negatively impact female quality of life.
ESPB is a safe, effective analgesic modality for post-breast surgery pain, and it is widely used nowadays under guidance of US, by injecting LA deep to ES muscle at the level of tip of TP of T4 mainly.
ESPB can be given in different positions such as sitting and lateral positions and changing the position may have an impact on the efficacy of the block.
Many cadaveric studies have been done to evaluate and understand the mechanism of action of ESPB and spread of LA.
The current study evaluated the effect of two different positions, sitting and lateral positions, on the efficacy of ESPB and the spread of LA.
It was done on 40 female patients who are ASA I or II, aging from 18 to 70 with a BMI ≤ 40, who were randomly divided in two groups, 20 per each.
In the first group, patients received ESPB in sitting position, while in the second group, patients received ESPB in lateral position, and in both groups 25 ml of 0.25% bupivacaine + 5 ml radiocontrast (Omnipaque 300®) and 8 mg dexamethasone were injected.
15 minutes After ESPB, CT scan of the thoracic region was performed. The spread of the injectate deep to ES muscle was evaluated using DICOM image processing for Mac (OsirixX, PixmeoSARL; Bern, Switzerland) and a three-dimensional digital reconstruction of the distribution of the injected