Costotransverse Foramen Block With Erector Spinae Plane Block in Modified Radical Mastectomy

Inclusion Criteria: * Adult females \> 18 years and ≤ 65 years old. * American Society of Anesthesiologists (ASA) physical status П-III. * Body mass index (BMI) 18-35 kg/m2. * Scheduled for modified radical mastectomy. Exclusion Criteria: * Known allergy or hypersensitivity to local anesthetic agents. * Active infection at the injection site (e.g., cellulitis, abscess). * Coagulopathy or ongoing anticoagulant/antiplatelet therapy \[International Normalized Ratio (INR) \> 1.5 or platelet count \< 100,000/µL\]. * Severe respiratory, cardiac, hepatic, or renal disease. * Morbid obesity. * Severe cognitive impairment or uncooperative behavior that could interfere with block placement.