الفهرس 
ANATOMY OF THE THORACIC WALL AND BREASTOnly 14 pages are availabe for public view
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Abstract
ABSTRACT
Background: Breast cancer has continued to be the most common cancer among women, accounting for 31% of all new cancer cases in the female population. Every/ year, thousands of patients undergo surgery in the region of the breast and axilla. Surgery is one of the mainstays of treatment, and a procedure called modified radical mastectomy (MRM) is now a standard surgical treatment for early-stage breast cancers.
Aim of the Work: The primary aim of this study is to compare the efficacy of PECS 1,2 block versus PCA with iv morphine to provide prolonged post-operative analgesia. The secondary objective is to identify the side effects of both techniques as post-operative analgesic techniques, as well as intra-operative analgesia.
Patients and Methods: A randomized controlled Clinical trial in Ain-shams University Hospitals, Cairo, Egypt (EL Demrdash hospital and Combined operations) for 6 months carried out on women who undergo breast surgeries.
Results: The Results shows that the VAS score in the PECS group was highly significant lower at the 1st,2nd and 4th hours postoperative, the time interval for the 1st dose of rescue analgesia was higher in PECS group, there was significant difference regarding heart rate and blood pressure between both groups at 1st,2nd, 4th and 8th hours postoperative in favor for PECS group, regarding o2 saturation it was significant only after 1 hour postoperative, regarding nausea and vomiting there was significant difference in nausea in favor for PECS block while regarding vomiting it was non-significant, regarding sedation it didn’t occur in neither group so it was not applicable.
Conclusion: In modified radical mastectomy, PECS block is more effective than intravenous PCA in pain management postoperative, better effect on vital data like heart rate, blood pressure and o2 saturation, it also lowers the analgesic drugs consumption postoperative. Moreover, PECS block is more preferable method because it avoids the systemic side effect of morphine used for PCA like nausea and vomiting. PCA analgesic effect needs time to start its action.