Ultrasound Guided Serratus Anterior Plane Block

Author: James Waiting, Tim Egan, Andrew Wilkinson / Editor: Frances Balmer / Codes: Echo / Published: 17/11/2021

Serratus anterior plane block can be used as multimodal analgesia for anterior lateral rib fractures in the trauma patient. This module outlines the ultrasound guided technique.

  • Understand the anatomy of serratus anterior plane block (SAPB).
  • Understand the indications for SAPB including rib fracture analgesia.
  • Be aware of the contraindications to SAPB.
  • Become familiar with the practicalities of performing an ultrasound-guided SAPB including local anaesthetic dose and monitoring.

References

  1. Witt CE, Bulger EM. Comprehensive approach to the management of the patient with multiple rib fractures: a review and introduction of a bundled rib fracture management protocol. Trauma surgery & acute care open, 2(1), e000064. [Accessed 1/5/21].
  2. Blanco R, Parras T, McDonnell J. G, Prats-Galino A. Serratus plane block: a novel ultrasound-guided thoracic wall nerve block. Anaesthesia, 68(11), 11071113. [Accessed 1/5/21]
  3. Durant E, Dixon B, Luftig J, et al. Ultrasound- guided serratus plane block for ED rib fracture pain control. American Journal of Emergency Medicine 2017; 35: 197.e36.(Accessed 1/5/21].
  4. Schnekenburger M, Mathew J, Fitzgerald M, et al. Regional anaesthesia for rib fractures: A pilot study of serratus anterior plane block. Emergency medicine Australasia : EMA, 2021, 33: 788-793. Advance online publication. [Accessed 1/5/21].
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  7. Rose, P., Ramlogan, R., Sullivan, T. et al. Serratus anterior plane blocks provide opioid-sparing analgesia in patients with isolated posterior rib fractures: a case series. Can J Anesth/J Can Anesth 66, 12631264, 2019.[Accessed 1/5/21].
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  10. Image1 – Cutaneous distribution of thoracic nerves. (Testut.). Fig.820. Henry Gray (18251861). Anatomy of the Human Body. 1918. Bartleby.
  11. Image2 – Diagram of the course and branches of a typica intercostal nerve. Fig.819. Henry Gray (18251861). Anatomy of the Human Body. 1918.

Additional Resources

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