Dexmedetomidine Versus Dexamethasone as Adjuncts in Erector Spinae Plane Block in Modified Radical Mastectomy

The block level will be at T5 with the patient in a sitting position and full aseptic precautions. T5 transverse process; these are recognizable as flat, squared-off acoustic shadows with only a very faint image of the pleura visible. In a longitudinal US view, in which the following layers will be visible superficial to the transverse processes: skin, subcutaneous tissue, trapezius, erector spinae muscle . Skin is topicalized, then echogenic block needle inserted in plane to the ultrasound beam in a cranial-to-caudal direction until contact is made with the T5 transverse process. After aspiration; to avoid intravascular injection, 30 ml of injectate is injected and separation will be seen. 6-13-MHz, linear transducer set for small parts and a depth of 4-6 cm will be used (18-19).