·To study the feasibility of not using opioids in breast-conserving surgery under general anesthesia with laryngeal mask airway.

·Forty female patients who underwent breast-conserving surgery for breast cancer were selected and randomly divided into an experimental group and a control group by random number table method, twenty cases in each. The experimental group underwent ultrasound-guided pectoral nerve block and serratus anterior plane block (SAPB) before induction, combined with dexmedetomidine and nonsteroidal anti-inflammatroy drug (NSAID) during the operation, and did not use opioids. The control group was given opioids without nerve block. The rest of the drugs were the same in both groups. The hemodynamic changes (systolic blood pressure, diastolic blood pressure and mean arterial pressure) of the patients at six time points were observed: before induction (T0), start induction (T1), 5 min after induction (T2), 10 min after induction (T3), incision (T4), and 5 min after incision (T5). The use of vasoactive agent, operation time, the recovery time of spontaneous breathing, laryngeal mask removal time, postoperative nausea, postoperative vomiting, postoperative delirium and visual analogue score (VAS) of patients in resuscitation room at rest and during activity, postoperative VAS at 6 h (at rest and during activity), and postoperative VAS at 24 h (at rest and during activity) between the two groups were compared.

·The differences in systolic blood pressure, diastolic blood pressure and mean arterial pressure between the two groups at time points T3 and T5 were statistically significant (all P<0.05). The differences in heart rate at time points T3, T4 and T5 were statistically significant (all P<0.05). One patient in the experimental group used vasoactive agent and six patients in the control group used vasoactive agent. No statistical difference was found between the recovery time of spontaneous breathing and laryngeal mask removal time in the two groups. No patients in the experimental group experienced postoperative nausea and vomiting. In the control group, two patients had nausea, and another two patients had nausea and vomiting. The resting VAS at 6 h after surgery in the experimental group was higher than that in the control group, and the result had statistical significance (P<0.05). Four patients in the experimental group took oral analgesic after surgery, and no patients in the control group used oral analgesic after surgery.

·Pectoral nerve block, and SAPB combined with dexmedetomidine and NSAID under ultrasound make it possible not to use opioids during breast-conserving surgery under general anesthesia with laryngeal mask airway. The postoperative analgesic effect needs to be improved.