Serratus Anterior Plane Block in the Emergency Department: A Case Series

Judy Lin, Taryn Hoffman, Ksenya Badashova, Sergey Motov, Lawrence Haines, Judy Lin, Taryn Hoffman, Ksenya Badashova, Sergey Motov, Lawrence Haines

Abstract

This is a case series of six emergency department (ED) patients who received an ultrasound-guided serratus anterior plane block (SAPB) for a variety of painful conditions. Our cases illustrate the feasibility and analgesic efficacy of the SAPB in providing pain management in ED patients with a variety of painful syndromes, including those with severe pain from multiple rib fractures, herpes zoster, and tube thoracostomy placement. In addition, we found no adverse events in our case series.

Conflict of interest statement

Conflicts of Interest: By the CPC-EM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none.

Copyright: © 2020 Lin et al.

Figures

Image 1
Image 1
Serratus anterior plane block external landmarks.
Image 2
Image 2
Serratus anterior plane block sono-anatomy. Yellow line, target plane; purple-dotted line, needle; blue line, pleura. SCT, subcutaneous tissue; SAM, serratus anterior muscle; LDM, latissimus dorsi muscle; ICM, Intercostal muscle.

References

    1. Blanco R, Parras T, McDonnell JG, et al. Serratus plane block: a novel ultrasound-guided thoracic wall nerve block. Anaesthesia. 2013;68:1107–13.
    1. Hetta DF, Rezk KM. Pectoralis-serratus interfascial plane block vs thoracic paravertebral block for unilateral radical mastectomy with axillary evacuation. J Clin Anesth. 2016;34:91–7.
    1. Khalil AE, Abdallah NM, Bashandy GM, et al. Ultrasound-guided serratus anterior plane block versus thoracic epidural analgesia for thoracotomy pain. J Cardiothorac Vasc Anesth. 2017;31(1):152–8.
    1. Künzli N, Ackermann-Liebrich U, Keller R, et al. Variability of FVC and FEV1 due to technician, team, device and subject in an eight centre study: three quality control studies in SAPALDIA. Swiss Study on Air Pollution and Lung Disease in Adults. Eur Respir J. 1995;8(3):371–6.
    1. Rahimzadeh P, Imani F, Faiz SHR, et al. Impact of the ultrasound-guided serratus anterior plane block on post-mastectomy pain: a randomised clinical study. Turk J Anaesthesiol Reanim. 2018;46(5):388–92.
    1. Madabushi R, Tewari S, Gautam SKS, et al. Serratus anterior plane block: a new analgesic technique for post-thoracotomy pain. Pain Physician. 2015;18(3):E421–4.
    1. May L, Hillermann C, Patil S. Rib fracture management. BJA Education. 2016;16(1):26–32.
    1. Flagel BT, Luchette FA, Reed RL, et al. Half-a-dozen ribs: the breakpoint for mortality. Surgery. 2005;138(4):717–23. discussion 723–5.
    1. Sirmali M, Türüt H, Topçu S, et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorc Surg. 2003;24(1):133–8.
    1. Quaday KA. Morbidity and mortality of rib fractures. J Trauma. 1995;39(3):617.
    1. O’Connell KM, Quistberg A, Tessler R, et al. Decreased risk of delirium with use of regional analgesia in geriatric trauma patients with multiple rib fractures. Ann Surg. 2018;268(3):534–40.
    1. Mackersie RC, Karagianes TG, Hoyt DB, et al. Prospective evaluation of epidural and intravenous administration of fentanyl for pain control and restoration of ventilatory function following multiple rib fractures. J Trauma. 1991;31(4):443–51.
    1. Durant E, Dixon B, Luftig J, et al. Ultrasound-guided serratus plane block for ED rib fracture pain control. Am J Emerg Med. 2017;35(1):197.e3–6.
    1. Chu GM, Jarvis GC. Serratus Anterior Plane Block to Address Postthoracotomy and Chest Tube-Related Pain: A Report on 3 Cases. AA Case Rep. 2017;8(12):322–5.
    1. Ahiskalioglu A, Alici HA, Yayik AM, et al. Ultrasound-guided serratus plane block for management of acute thoracic herpes zoster. Anaesth Crit Care Pain Med. 2017;36(5):323–4.

Source: PubMed

Спонсоры и соавторы

Заболевания

Медикаментозные вмешательства

Подписаться