Stellate Ganglion Destruction With Alcohol Versus Thermal Ablation for Chronic Post Mastectomy Pain

Inclusion Criteria: * Female patient 20-65yrs underwent surgery for breast cancer * Pain duration of more than 6 months * Pain is moderate to severe pain (visual analog scale \[VAS\] ≥ 4 cm), * Pain described as a refractory one that is defined as pain for which classic biomedical therapy has proven ineffective * Pain is of positive neuropathic character as detected by the grading system for neuropathic pain (GSNP), with a score of 3 or 4 Exclusion Criteria: * Refusal of the patient * Recent myocardial infarction * Anti-coagulated patients or coagulopathy (evaluate risk/benefit ratio) * Glaucoma * Pre-existing counter lateral nerve palsy * Severe emphysema * Cardiac conduction block * Local and systemic sepsis * Local anatomical distortion (which may render the block technically difficult or hazardous. * Psychiatric illness.