At the request of Dr. Soo. Let’s review about serratus anterior planar block!
Indication: chest tube insertion, multiple rib fractures
Materials needed: US machine, sterile glove, probe cover, sterile gel, long spinal needle, sterile drape, IV extension/tubing, 30cc syringe, anesthetic
Anesthetic: typically 30cc of 0.25% bupivacaine
Landmarks: latissimus dorsi, serratus anterior, ribs, pleural line
Techniques:
Approach can be anterior or posterior (which is preferred if patient is able to be positions)
Local anesthetic can be deposit above the serratus (1st pic), or below (2nd pic) on top of rib
Complications: PTX, LAST therefore patient needs to be on monitor as it’s a large volume block, subcutaneous emphysema
For more info:
https://painandpsa.org/rnb/ (BY OUR OWN DRs. ODASHIMA AND DICKMAN!)