Comparison of Adding Magnesium Sulphate to Bupivacaine with Plain Bupivacaine in Ultrasound Guided Pectoral Nerve Block for Postoperative Analgesia in Modified Radical Mastectomy

Abstract Background Breast cancer is the most common malignancy in women, and its incidence continues to increase. Modified radical mastectomy (MRM) is one of the standard treatments for multi-centric disease or tumors with extensive coexistent ductal carcinoma in situ. Aim of the Study To elaborate the analgesic efficiency and safety of pectoral nerve block by adding magnesium sulphate to bupivacaine as an adjuvant versus bupivacaine as a sole agent in cases of modified radical mastectomy (MRM). Patients and Methods This is a Prospective double – blinded randomized controlled study was conducted in the operating theatres of Ain Shams University Hospitals. It included Female patients undergoing Modified Radical Mastectomy. Twenty-four patients were enrolled in the study divided into 12 patients in each group. Results There was a statistically significant difference between 2 groups according to post-operative visual analogue scale. It was lower in consumption in group B than in group A. Also a statistically significant difference between group A and group B according to first time of rescue morphine consumption was found, it was longer time to need postoperative morphine consumption in group B than in group A And we found the addition of 300 mg of magnesium sulfate to bupivacaine in an ultrasound-guided Pectoral Nerve Block significantly prolong the duration of the analgesia, and reduce the VAS score without significant side effects after Modified Radical Mastectomy under general anesthesia. Conclusion The addition of 300 mg of magnesium sulfate to bupivacaine in an ultrasound-guided Pectoral Nerve Block significantly prolong the duration of the analgesia, and reduce the VAS score without significant side effects after Modified Radical Mastectomy under general anesthesia