protocolSection identificationModule nctId: NCT06371625, orgStudyIdInfo id: AP2202-30104, briefTitle: U/S Guided Transversus Thoracic and Pectoral Nerve Block Versus Pectoral Nerve Block in MRM, statusModule overallStatus: COMPLETED, startDateStruct date: 2022-07-02, primaryCompletionDateStruct date: 2023-08-01, completionDateStruct date: 2023-10-01, studyFirstPostDateStruct date: 2024-04-17, lastUpdatePostDateStruct date: 2024-04-22, sponsorCollaboratorsModule leadSponsor name: Ahmed Mohamed Soliman, class: OTHER, descriptionModule briefSummary: Interfascial blocks score over regional anesthetic techniques such as Transversus Thoracic Plane Block and Pectoral Nerves (PECS) Block as they have no risk of sympathetic blockade, intrathecal or epidural spread, which may lead to hemodynamic instability and prolonged hospital stay. The transversus thoracic muscle plane block (TTP) block is a newly developed regional anesthesia technique which provides analgesia to the anterior chest wall. First described by Ueshima et al. in 2015, the TTP block is a single-shot nerve block that deposits local anesthetic in the transversus thoracic muscle plane between the internal intercostal and transversus thoracic muscles. TTP block targets the anterior branches of the intercostal nerves (T2-6).Pectoral plane blocks are recently described . PECS block involves deposition of local anesthetic drug between muscle planes. PECS I block, between Pectoralis Major and Minor at third rib level, and PECS II block, the drug is deposited between Pectoralis minor and Serratus anterior muscle.The pectoral nerves (PECS) block provides analgesia of the lateral mammary region, the intercostobrachial and lateral cutaneous branches of the intercostal nerves (T2-T6), the medial cutaneous nerve of the arm and forearm, and the long thoracic and thoracodorsal nerves. The modified PECS block produces excellent analgesia and can be used to provide balanced anesthesia., conditionsModule conditions: Breast Cancer, conditions: Analgesia, designModule studyType: INTERVENTIONAL, phases: NA, designInfo allocation: RANDOMIZED, interventionModel: PARALLEL, interventionModelDescription: to determine the analgesic effect of ultrasound guided Transversus Thoracic and Pectoral Nerve Block compared to ultrasound guided Pectoral Nerve Block in patients undergoing modified radical mastectomy regarding the following : 1-Post-operative opioid (morphine) consumption in the 1st 24 hours 2- Postoperative Numeric Pain Rating Scale. 3. Effect on hemodynamics: Mean arterial blood pressure and Heart rate. 4. Intraoperative fentanyl consumption. 5. Duration of analgesic effect, primaryPurpose: SUPPORTIVE_CARE, maskingInfo masking: DOUBLE, maskingDescription: The patients will be randomly assigned into two equal comparable groups using computer- generated random numbers in opaque closed envelopes, each of which will include 11 per group. Randomization will be done by statistician and each group of the patient will revealed only when the included patient is transferred to preanesthetic room., whoMasked: PARTICIPANT, whoMasked: INVESTIGATOR, enrollmentInfo count: 22, type: ACTUAL, armsInterventionsModule interventions name: Transeversus Thoracic Plane Block (TTPB) and Pectoral Nerves (PECS) Block, interventions name: Pectoral Nerves (PECS) Block, outcomesModule primaryOutcomes measure: visual analogue scale "VAS score", secondaryOutcomes measure: total morphine consumption, secondaryOutcomes measure: mean blood pressure, secondaryOutcomes measure: heart rate, secondaryOutcomes measure: first analgesic dose, eligibilityModule sex: FEMALE, minimumAge: 20 Years, maximumAge: 60 Years, stdAges: ADULT, contactsLocationsModule locations facility: National cancer Insititute Cairo university, city: Cairo, zip: 11796, country: Egypt, geoPoint lat: 30.06263, lon: 31.24967, locations facility: National cancer Insititute, city: Cairo, zip: 11796, country: Egypt, geoPoint lat: 30.06263, lon: 31.24967, locations facility: Ahmed Mohamed Soliman, city: Giza, country: Egypt, geoPoint lat: 30.00808, lon: 31.21093, hasResults: False