Abstract
Introduction: Awake thoracic surgery is an old procedure still being used to this day for various indications, utilizing many different techniques for local analgesia. Case Presentation: We described the case of a 60-year-old obese heavy smoker, with significant respiratory and cardiac morbidity, who presented with signs of cardiac tamponade secondary to hypothyroidism. Our patient was treated with a pericardial window, using serratus anterior and parasternal blocks. Discussion: We presented the first case to our knowledge that employed parasternal and serratus anterior blocks as local analgesia for an awake thoracotomy, we also discussed different techniques, indications, benefits, and complications.