Aim of this study is to determine the success of combined serratus anterior and PECS-2 block as the main anesthetic method in breast cancer surgery and also to investigate the patient acceptability of this combination and its relationship with surgeon satisfaction.

Breast conserving surgery or mastectomy is applied in the surgical treatment of breast cancer. Axillary interventions range from sentinal lymph node biopsy to lymph node dissection. Clinically significant acute pain develops following breast surgery in 35% of patients.

Today, regional anesthesia is widely used as an opioid-sparing strategy in the treatment of acute postoperative pain. New fascial plane blocks have been developed as alternative or complementary techniques for chest wall analgesia, including pectoral nerve blocks (PECS1-2) and serratus plane block.

In order to reduce the risk of perioperative morbidity and mortality and to meet the patient demand, the demand for awake surgery is increasing in institutions.

Therefore, a prospective observational case series was conducted to explain the efficacy, patient acceptability, and surgeon satisfaction of combined serratus anterior and PECS-2 block as the main anesthetic method for breast cancer surgery.

Inclusion Criteria:

• Patients between the ages of 18-80 and ASA I-III who will undergo unilateral breast cancer surgery will be included in the study.

Exclusion Criteria:

• Patients with previous breast surgery other than excisional biopsy,
• coagulopathy,
• bleeding disease,
• local infection at the injection site,
• history of local anesthetic allergy,
• psychiatric disease (depression, mania, schizophrenia or antipsychotic drug use),
• history of opioid use for more than 4 weeks
• Patients with body mass index (BMI) >40kg/m2 and
• chest deformity (pectus excavatum and pectus carinatum) will be excluded from the study.

Female patients aged 18-80 years with breast cancer