Rhomboid Intercostal Block With Sub-Serratus Plane Block Versus Erector Spinae Block

This study compares two nerve block techniques-Rhomboid Intercostal with Sub-Serratus Plane Block versus Erector Spinae Plane Block-for pain relief after breast cancer surgery. It aims to determine which method provides better postoperative pain control, reduces opioid use, and improves recovery in patients undergoing modified radical mastectomy at the National Cancer Institute, Cairo University.

Inclusion Criteria: * Female breast cancer patients undergoing Modified Radical Mastectomy (MRM) ASA physical status II or III Age between 18 and 65 years Body Mass Index (BMI) \> 20 kg/m² and \< 35 kg/m² Exclusion Criteria: * Patient refusal ASA physical status IV Age \65 years BMI \< 20 kg/m² or \> 35 kg/m² Known allergy or contraindication to local anesthetics or opioids History of psychological disorders or chronic pain Contraindications to regional anesthesia (e.g., coagulopathy, local infection, peripheral neuropathy) Severe respiratory, cardiac, hepatic, or renal disease