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Serratus Anterior Plane Block
Rafael Vazquez, MD; Nicole Z. Spence, MD
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KEY FACTS

  • Terminology

    • Preprocedure

      • Procedure

        • Post Procedure

          • Outcomes

            TERMINOLOGY

            • Abbreviations

              • Serratus anterior plane (SAP)
              • Serratus anterior muscle (SAM)
              • Latissimus dorsi muscle (LDM)
              • Teres major muscle (TMM)
            • Definitions

              • Fascial plane block of lateral cutaneous branches of thoracic intercostal nerves, intercostobrachial nerve, long thoracic nerve, and thoracodorsal nerve, providing somatic analgesia to hemithorax, specifically anterolateral chest wall and axilla

            PREPROCEDURE

            • Indications

              • Contraindications

                • Getting Started

                  PROCEDURE

                  • Patient Position/Location

                    • Equipment Preparation

                      • Procedure Steps

                        • Findings and Reporting

                          • Alternative Procedures/Therapies

                            POST PROCEDURE

                            • Expected Outcome

                              • Things to Do

                                • Things to Avoid

                                  OUTCOMES

                                  • Problems

                                    • Complications

                                      Selected References

                                      1. Bhatt HV et al: Serratus anterior plane block for transapical off-pump mitral valve repair with NeoChord implantation. J Cardiothorac Vasc Anesth. 33(7):2105-7, 2019
                                      2. Kazior MR et al: Serratus anterior plane block for minimally invasive valve surgery thoracotomy pain. J Clin Anesth. 56:48-9, 2019
                                      3. Khemka R et al: Ultrasound-guided modified serratus anterior plane block for perioperative analgesia in breast oncoplastic surgery: a case series. Indian J Anaesth. 63(3):231-4, 2019
                                      4. Lee J et al: The effects of ultrasound-guided serratus plane block, in combination with general anesthesia, on intraoperative opioid consumption, emergence time, and hemodynamic stability during video-assisted thoracoscopic lobectomy: a randomized prospective study. Medicine (Baltimore). 98(18):e15385, 2019
                                      5. Miller MA et al: Feasibility of subcutaneous implantable cardioverter-defibrillator implantation with opioid sparing truncal plane blocks and deep sedation. J Cardiovasc Electrophysiol. 30(1):141-8, 2019
                                      6. Rose P et al: Serratus anterior plane block home catheter for posterior rib fractures and flail chest. Can J Anaesth. 66(8):997-8, 2019
                                      7. Semyonov M et al: Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery. J Pain Res. 12:953-60, 2019
                                      8. Tore Altun G et al: Ultrasound-guided serratus anterior plane block for pain management following minimally invasive repair of pectus excavatum. J Cardiothorac Vasc Anesth. 33(9):2487-91, 2019
                                      9. Bakr MA et al: Effect of dexmedetomidine added to modified pectoral block on postoperative pain and stress response in patient undergoing modified radical mastectomy. Pain Physician. 21(2):E87-96, 2018
                                      10. Bhoi D et al: Comparison of two different techniques of serratus anterior plane block: a clinical experience. J Anaesthesiol Clin Pharmacol. 34(2):251-3, 2018
                                      11. Biswas A et al: Serratus plane block: a cadaveric study to evaluate optimal injectate spread. Reg Anesth Pain Med. 43(8):854-8, 2018
                                      12. Droghetti A et al: Ultrasound-guided serratus anterior plane block combined with the two-incision technique for subcutaneous ICD implantation. Pacing Clin Electrophysiol. 41(5):517-23, 2018
                                      13. Elsharkawy H et al: Rhomboid intercostal and subserratus plane block: a cadaveric and clinical evaluation. Reg Anesth Pain Med. 43(7):745-51, 2018
                                      14. Kaur RP et al: Serratus anterior plane block versus thoracic epidural analgesia for post-thoracotomy pain relief. J Cardiothorac Vasc Anesth. 32(6):e11-2, 2018
                                      15. Sir E et al: A novel technique: ultrasound-guided serratus anterior plane block for the treatment of post-traumatic intercostal neuralgia. a case report. Am J Phys Med Rehabil. ePub, 2018
                                      16. Fu P et al: Case report of serratus plane catheter for pain management in a patient with multiple rib fractures and an inferior scapular fracture. A A Case Rep. 8(6):132-5, 2017
                                      17. Khalil AE et al: Ultrasound-guided serratus anterior plane block versus thoracic epidural analgesia for thoracotomy pain. J Cardiothorac Vasc Anesth. 31(1):152-8, 2017
                                      18. Kunigo T et al: Injection volume and anesthetic effect in serratus plane block. Reg Anesth Pain Med. 42(6):737-40, 2017
                                      19. Kunhabdulla NP et al: Serratus anterior plane block for multiple rib fractures. Pain Physician. 17(5):E651-3, 2014
                                      20. Blanco R et al: Serratus plane block: a novel ultrasound-guided thoracic wall nerve block. Anaesthesia. 68(11):1107-13, 2013
                                      Related Anatomy
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                                      Related Differential Diagnoses
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                                      References
                                      Tables

                                      Tables

                                      KEY FACTS

                                      • Terminology

                                        • Preprocedure

                                          • Procedure

                                            • Post Procedure

                                              • Outcomes

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Serratus anterior plane (SAP)
                                                  • Serratus anterior muscle (SAM)
                                                  • Latissimus dorsi muscle (LDM)
                                                  • Teres major muscle (TMM)
                                                • Definitions

                                                  • Fascial plane block of lateral cutaneous branches of thoracic intercostal nerves, intercostobrachial nerve, long thoracic nerve, and thoracodorsal nerve, providing somatic analgesia to hemithorax, specifically anterolateral chest wall and axilla

                                                PREPROCEDURE

                                                • Indications

                                                  • Contraindications

                                                    • Getting Started

                                                      PROCEDURE

                                                      • Patient Position/Location

                                                        • Equipment Preparation

                                                          • Procedure Steps

                                                            • Findings and Reporting

                                                              • Alternative Procedures/Therapies

                                                                POST PROCEDURE

                                                                • Expected Outcome

                                                                  • Things to Do

                                                                    • Things to Avoid

                                                                      OUTCOMES

                                                                      • Problems

                                                                        • Complications

                                                                          Selected References

                                                                          1. Bhatt HV et al: Serratus anterior plane block for transapical off-pump mitral valve repair with NeoChord implantation. J Cardiothorac Vasc Anesth. 33(7):2105-7, 2019
                                                                          2. Kazior MR et al: Serratus anterior plane block for minimally invasive valve surgery thoracotomy pain. J Clin Anesth. 56:48-9, 2019
                                                                          3. Khemka R et al: Ultrasound-guided modified serratus anterior plane block for perioperative analgesia in breast oncoplastic surgery: a case series. Indian J Anaesth. 63(3):231-4, 2019
                                                                          4. Lee J et al: The effects of ultrasound-guided serratus plane block, in combination with general anesthesia, on intraoperative opioid consumption, emergence time, and hemodynamic stability during video-assisted thoracoscopic lobectomy: a randomized prospective study. Medicine (Baltimore). 98(18):e15385, 2019
                                                                          5. Miller MA et al: Feasibility of subcutaneous implantable cardioverter-defibrillator implantation with opioid sparing truncal plane blocks and deep sedation. J Cardiovasc Electrophysiol. 30(1):141-8, 2019
                                                                          6. Rose P et al: Serratus anterior plane block home catheter for posterior rib fractures and flail chest. Can J Anaesth. 66(8):997-8, 2019
                                                                          7. Semyonov M et al: Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery. J Pain Res. 12:953-60, 2019
                                                                          8. Tore Altun G et al: Ultrasound-guided serratus anterior plane block for pain management following minimally invasive repair of pectus excavatum. J Cardiothorac Vasc Anesth. 33(9):2487-91, 2019
                                                                          9. Bakr MA et al: Effect of dexmedetomidine added to modified pectoral block on postoperative pain and stress response in patient undergoing modified radical mastectomy. Pain Physician. 21(2):E87-96, 2018
                                                                          10. Bhoi D et al: Comparison of two different techniques of serratus anterior plane block: a clinical experience. J Anaesthesiol Clin Pharmacol. 34(2):251-3, 2018
                                                                          11. Biswas A et al: Serratus plane block: a cadaveric study to evaluate optimal injectate spread. Reg Anesth Pain Med. 43(8):854-8, 2018
                                                                          12. Droghetti A et al: Ultrasound-guided serratus anterior plane block combined with the two-incision technique for subcutaneous ICD implantation. Pacing Clin Electrophysiol. 41(5):517-23, 2018
                                                                          13. Elsharkawy H et al: Rhomboid intercostal and subserratus plane block: a cadaveric and clinical evaluation. Reg Anesth Pain Med. 43(7):745-51, 2018
                                                                          14. Kaur RP et al: Serratus anterior plane block versus thoracic epidural analgesia for post-thoracotomy pain relief. J Cardiothorac Vasc Anesth. 32(6):e11-2, 2018
                                                                          15. Sir E et al: A novel technique: ultrasound-guided serratus anterior plane block for the treatment of post-traumatic intercostal neuralgia. a case report. Am J Phys Med Rehabil. ePub, 2018
                                                                          16. Fu P et al: Case report of serratus plane catheter for pain management in a patient with multiple rib fractures and an inferior scapular fracture. A A Case Rep. 8(6):132-5, 2017
                                                                          17. Khalil AE et al: Ultrasound-guided serratus anterior plane block versus thoracic epidural analgesia for thoracotomy pain. J Cardiothorac Vasc Anesth. 31(1):152-8, 2017
                                                                          18. Kunigo T et al: Injection volume and anesthetic effect in serratus plane block. Reg Anesth Pain Med. 42(6):737-40, 2017
                                                                          19. Kunhabdulla NP et al: Serratus anterior plane block for multiple rib fractures. Pain Physician. 17(5):E651-3, 2014
                                                                          20. Blanco R et al: Serratus plane block: a novel ultrasound-guided thoracic wall nerve block. Anaesthesia. 68(11):1107-13, 2013