Serratus plane block: do we need to learn another technique for thoracic wall blockade?

Intercostal/paraspinal nerve block for thoracic surgery

“…Recently, Anaesthesia has carried a number of descriptions of chest wall nerve blocks, derived from serratus plane block [1][2][3][4].…”

“…Catheter position within this space and continuous infusion of 8 ml.h À1 ropivacaine 0.2% can be used to provide analgesia for two or three days postoperatively. Single operator techniques have been highlighted in this journal in the past [2,3], such as the 'Jedi Hand Grip' where both the regional block needle and syringe are held in one hand and the ultrasound probe is held in the other. This method is supposed to have the advantage of providing tactile feedback about injection pressure, whilst allowing the operator the opportunity to concentrate on events displayed on the ultrasound screen.…”

Too Deep or Not Too Deep?

“…7 Described by Blanco and colleagues, 8 the block targets the lateral cutaneous branches of the intercostal nerves as they traverse either of 2 fascial planes: superficial to the serratus muscle or deep to the serratus muscles. Although both the superficial and deep approaches produced sensory blockade, Blanco et al 8 concluded that the superficial plane is more effective based on radiographic and sensory observations in 4 volunteers; however, these observations may not accurately reflect the true analgesic effects in surgical patients.…”

Recent advances in regional anaesthesia

“…[8] The paper however, captured the attention of the regional anaesthesia practitioners and there were various letters about this technique and its applications. These helped to clarify certain aspects of this block [9e12].…”