Ultrasound-Guided Serratus Anterior Blocks

Samuel J. Southgate, Meghan K. Herbst, Samuel J. Southgate, Meghan K. Herbst

Excerpt

Approximately 10% of injured patients presenting to the emergency department (ED) demonstrate rib fractures. Rib fractures are associated with significant morbidity and mortality, especially in the elderly. Pulmonary complications, including pneumonia, often become apparent 2 or 3 days after injury, when respiratory function is compromised, secondary to pain. Therefore, effective analgesia is an important component of rib fracture management. Intravenous opioids are a mainstay of treatment but have side effects, including respiratory depression, depressed cough reflex, and delirium in the elderly. The serratus anterior plane block (SAPB) is an alternative that has become popular due to its efficacy, relative ease, and limited side-effect profile.

Conflict of interest statement

Disclosure: Samuel Southgate declares no relevant financial relationships with ineligible companies.

Disclosure: Meghan Herbst declares no relevant financial relationships with ineligible companies.

Copyright © 2023, StatPearls Publishing LLC.

References

    1. Lotfipour S, Kaku SK, Vaca FE, Patel C, Anderson CL, Ahmed SS, Menchine MD. Factors associated with complications in older adults with isolated blunt chest trauma. West J Emerg Med. 2009 May;10(2):79-84.
    1. Khalil AE, Abdallah NM, Bashandy GM, Kaddah TA. Ultrasound-Guided Serratus Anterior Plane Block Versus Thoracic Epidural Analgesia for Thoracotomy Pain. J Cardiothorac Vasc Anesth. 2017 Feb;31(1):152-158.
    1. Park MH, Kim JA, Ahn HJ, Yang MK, Son HJ, Seong BG. A randomised trial of serratus anterior plane block for analgesia after thoracoscopic surgery. Anaesthesia. 2018 Oct;73(10):1260-1264.
    1. Smith R, Nyquist-Battie C, Clark M, Rains J. Anatomical characteristics of the upper serratus anterior: cadaver dissection. J Orthop Sports Phys Ther. 2003 Aug;33(8):449-54.
    1. Blanco R, Parras T, McDonnell JG, Prats-Galino A. Serratus plane block: a novel ultrasound-guided thoracic wall nerve block. Anaesthesia. 2013 Nov;68(11):1107-13.
    1. Biswas A, Castanov V, Li Z, Perlas A, Kruisselbrink R, Agur A, Chan V. Serratus Plane Block: A Cadaveric Study to Evaluate Optimal Injectate Spread. Reg Anesth Pain Med. 2018 Nov;43(8):854-858.
    1. Piracha MM, Thorp SL, Puttanniah V, Gulati A. "A Tale of Two Planes": Deep Versus Superficial Serratus Plane Block for Postmastectomy Pain Syndrome. Reg Anesth Pain Med. 2017 Mar/Apr;42(2):259-262.
    1. Mayes J, Davison E, Panahi P, Patten D, Eljelani F, Womack J, Varma M. An anatomical evaluation of the serratus anterior plane block. Anaesthesia. 2016 Sep;71(9):1064-9.
    1. Durant E, Dixon B, Luftig J, Mantuani D, Herring A. Ultrasound-guided serratus plane block for ED rib fracture pain control. Am J Emerg Med. 2017 Jan;35(1):197.e3-197.e6.
    1. Zocca JA, Chen GH, Puttanniah VG, Hung JC, Gulati A. Ultrasound-Guided Serratus Plane Block for Treatment of Postmastectomy Pain Syndromes in Breast Cancer Patients: A Case Series. Pain Pract. 2017 Jan;17(1):141-146.
    1. El-Boghdadly K, Pawa A, Chin KJ. Local anesthetic systemic toxicity: current perspectives. Local Reg Anesth. 2018;11:35-44.
    1. Strayer RJ, Motov SM, Nelson LS. Something for pain: Responsible opioid use in emergency medicine. Am J Emerg Med. 2017 Feb;35(2):337-341.
    1. Hoppe JA, Kim H, Heard K. Association of emergency department opioid initiation with recurrent opioid use. Ann Emerg Med. 2015 May;65(5):493-499.e4.
    1. Barnett ML, Olenksi AR, Jena AB. Opioid Prescribing by Emergency Physicians and Risk of Long-Term Use. N Engl J Med. 2017 May 11;376(19):1896.

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera