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Abstract Our study was conducted on patients in surgical oncology department and postoperative anesthesia care unit (PACU) in South Egypt Cancer Institute (SECI), Assuit University, Egypt, after obtaining Hospital Ethical Committee approval; it was prospectively registered at “www.clinicaltrial.gov” under number: (NCT04275661). Written informed consent from sixtey ASA I-II female patients aged 18-60 years, weighted from 50-90 Kg and scheduled for modified radical mastectomy (MRM) breast cancer was obtained. Excluded from the study were patients with known allergy to the study drugs, significant cardiac, respiratory, renal or hepatic disease, drug or alcohol abuse, and psychiatric illness that would interfere with perception and assessment of pain Our aim was to compare the analgesic efficacy and safety of ketamine and magnesium sulphate as adjuvants to levobupivacaine in erector spinae plane block in modified radical mastectomy Patients were randomly allocated into 3 groups (20 patients each) using online research randomizer computer program into one of 3 groupsgroup (C) / (I): 20 patients (control group) Patient will receive 20 ml 0.25% levobupivacaine into interfascial plane below erector spinae muscle at level of T5 and T7 group (K) / (II): 20 patients (Ketamine group) Patient will receive 20ml 0.25% levobupivacaine as above + 2 mg/kg ketamine group (M) / (III): 20 patients (magnesium sulphate group) Patient will receive 20ml 0.25% levobupivacaine as above + 2mg/kg MgSO4. |