Introduction: Breast surgery can be emotionally distressing and physically painful. Although regional anesthesia and nerve block techniques are widely used in many situations, many anesthetists are still minded by the simplest way of wound infiltration. Preemptive analgesia is the concept of providing analgesia before surgical incision. Suggested advantages of this technique include a reduction in postoperative pain, analgesic consumption and an improvement in patient satisfaction. In addition adverse effect of opioids consumption such as postoperative nausea and vomiting, drowsiness and risk of respiratory depression can be minimized. Aims & Objective: To evaluate the efficacy of preincision mastectomy flap infiltration with a cocktail of bupivacaine 0.5% and lignocaine with adrenaline over intraoperative and postoperative analgesic requirement compared with patients receiving placebo. To investigate the efficacy of preincision local anesthetic regimen infiltration in postoperative pain score in modified radical mastectomy compared with patients receiving placebo. To study their effect on hemodynamic parameters, any side effects and complication. Material and method: In this randomized single blinded study, 60 patients of ASA grade I and II posted for modified radical mastectomy were randomized into group I and group II. Group I receive pre incision infiltration of mastectomy flap with cocktail of 10 ml bupivacaine (0.5%)+10 ml of lignocaine 2% with adrenaline, Group II receive pre incision infiltration with 20 ml normal saline. All patients undergo standardized general anaesthesia. We assessed intraoperative requirement of analgesic drugs,haemodynamic parameters, postoperative supplementary analgesia, VAS score and side effects. Results: There was no statistical difference between both groups regarding the demographic data. The mean blood pressure, pulse rate was less in group I which was statically significant. The mean supplementary analgesic requirement was significantly less in group I. The postoperative VAS score was significantly less in study group. Conclusion: Preemptive local anaesthetic infiltration at the incision site is safe and effective method for reducing postoperative pain and stress response with a significant reduction of analgesic requirement.