{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T07:51:14Z","timestamp":1791186674244,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T00:00:00Z","timestamp":1791072000000},"content-version":"vor","delay-in-days":276,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Breast Journal"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Erector spinae plane block (ESPB) and modified pectoral nerve block (PECS\u2010II) are being increasingly used to control pain following breast surgeries. However, evidence comparing their effects on postoperative analgesia and surgical stress response is limited. The current study compared analgesic efficacy and surgical stress response attenuation of ESPB and PECS\u2010II in patients undergoing modified radical mastectomy (MRM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective, randomised, comparative study, 42 patients undergoing elective MRM were randomly divided to receive either ESPB or PECS\u2010II. Both groups received 30\u2009mL of 0.2% ropivacaine with 0.5\u2009\u03bcg\/kg dexmedetomidine after induction of general anaesthesia (GA). The primary outcome was time to first rescue analgesia requirement. Secondary outcomes were postoperative numerical rating scale (NRS) scores, rescue analgesic consumption, intraoperative fentanyl requirement, serum cortisol, interleukin\u20106 (IL\u20106) and neutrophil\u2010to\u2010lymphocyte ratio (NLR), patient satisfaction and block\u2010related complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean time to first rescue analgesia was significantly larger in the PECS\u2010II group than in the ESPB group (9.05\u2009\u00b1\u20091.12\u2009h vs 6.95\u2009\u00b1\u20091.16\u2009h;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Patients receiving PECS\u2010II had lower 24\u2010h diclofenac (114.3\u2009\u00b1\u200938.4\u2009mg vs 146.4\u2009\u00b1\u200916.4\u2009mg;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002) and tramadol consumption (7.1\u2009\u00b1\u200917.9\u2009mg vs 23.8\u2009\u00b1\u200925.6\u2009mg;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021). NRS scores were lower in the PECS\u2010II group at 6\u2009h postoperatively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Intraoperative fentanyl requirement was comparable between the two groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.133). Postoperative serum cortisol (363.48\u2009\u00b1\u200941.79 vs 495.95\u2009\u00b1\u200952.20\u2009nmol\/L), IL\u20106 (14.48\u2009\u00b1\u20094.39 vs 24.43\u2009\u00b1\u20096.33 pg\/mL) and NLR (4.15\u2009\u00b1\u20090.55 vs 4.98\u2009\u00b1\u20090.85) were also lower in the PECS\u2010II group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.001). Patient satisfaction scores were higher following PECS\u2010II (5.62\u2009\u00b1\u20090.74 vs 5.05\u2009\u00b1\u20090.67;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022). No block\u2010related complications were observed in either group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PECS\u2010II provided longer postoperative analgesia than ESPB in patients undergoing MRM under GA. Exploratory analyses showed lower postoperative analgesic consumption, lower pain scores at 6\u2009h, lower postoperative stress response markers and higher patient satisfaction with PECS\u2010II. These secondary findings should be considered hypothesis\u2010generating and warrant confirmation in larger, adequately powered studies. Intraoperative fentanyl requirement was comparable between the two groups.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      Clinical Trials Registry: CTRI\/2024\/04\/066198\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/tbj\/2712790","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T06:55:39Z","timestamp":1791183339000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of Modified Pectoral Nerve Block and Erector Spinae Plane Block for Postoperative Analgesia and Surgical Stress Response Following Modified Radical Mastectomy: A Prospective, Randomised, Blinded Study"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7276-1386","authenticated-orcid":false,"given":"Avnika","family":"Laller","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Maulana Azad Medical College and Associated Hospitals  New Delhi India  mamc.ac.in"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7291-5961","authenticated-orcid":false,"given":"Lalit","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Maulana Azad Medical College and Associated Hospitals  New Delhi India  mamc.ac.in"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8623-5326","authenticated-orcid":false,"given":"Devang","family":"Bharti","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Maulana Azad Medical College and Associated Hospitals  New Delhi India  mamc.ac.in"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6018-3406","authenticated-orcid":false,"given":"Kapil","family":"Chaudhary","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Maulana Azad Medical College and Associated Hospitals  New Delhi India  mamc.ac.in"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,4]]},"reference":[{"key":"e_1_2_14_1_2","doi-asserted-by":"publisher","DOI":"10.5306\/wjco.v13.i3.209"},{"key":"e_1_2_14_2_2","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1016\/B978-0-323-35955-9.00031-3","volume-title":"The Breast","author":"Bland K. 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