We decided to terminate this study due to staffing changes and other limitations posed by the COVID-19 pandemic.

This is a randomized, double-blinded, placebo-controlled trial of serratus plane blocks in subjects undergoing outpatient unilateral or bilateral breast surgery. Ninety subjects will be enrolled into the study at presurgical testing. Subjects will be stratified based on surgery type and randomized to receive a serratus plane block with either bupivicaine HCL or placebo. All patients will receive standard intraoperative anesthesia and standard postoperative pain control. The primary endpoint is the amount of opioid administered postoperatively. Secondary endpoints include postoperative pain intensity at timed intervals, amount of opioid administered intraoperatively and postoperatively, incidence of nausea and vomiting, time to discharge and patient satisfaction

Inclusion Criteria:

• ASA I-III.
• Undergoing outpatient breast surgery requiring general anesthesia, including but not limited to mastectomy, lumpectomy, reconstruction with tissue expanders or implants and reconstruction revision.

Exclusion Criteria:

• Unable to provide informed consent.
• Patients who are pregnant or nursing.
• ASA IV-V.
• Alcohol or narcotic dependence in the last 2 years.
• Concurrent condition requiring regular use of analgesia that may confound post-surgical assessments as determined by principle investigator.
• Hepatic disease.
• Allergies to amide anesthetics as determined from medical history or patient self-report.
• Evidence of infection at injection site.
• Contraindication to pain medications such as acetominophen, morphine, oxycodone, keterolac, dilaudid, Toradol.
• Body weight <50kg.
• BMI>40kg/m2.
• History of hypotension.
• Abnormal renal (creatinine > 1.5 mg/dL) function.
• Heart block.
• Any physical, mental or medical condition, that in the opinion of the investigator, makes study participation inadvisable.

At pre-surgical testing, subjects screened will be recruited into the trial.

The protocol states that all adverse events occurring during the study period will be recorded. The clinical course of each event will be followed until resolution, stabilization, or until it has been determined that the study treatment or participation is not the cause. This will occur through study completion, an average of 1 year.

The investigator will seek information on AE by monitoring while subject is under anesthesia, specific questioning and by examination. All related signs, symptoms, and abnormal diagnostic procedures results will be recorded in the source document. All AEs occurring during the study period will be recorded. The clinical course of each event will be followed until resolution, stabilization, or until it has been determined that the study treatment or participation is not the cause