title: An anatomical evaluation of the serratus anterior plane block.
abstract: The serratus anterior plane block has been described for analgesia of the hemithorax. This study was conducted to determine the spread of injectate and investigate the anatomical basis of the block. Ultrasound-guided serratus anterior plane block was performed on six soft-fix embalmed cadavers. All cadavers received bilateral injections, on one side performed with 20 ml latex and on the other with 20 ml methylene blue. Subsequent dissection explored the extent of spread and nerve involvement. Photographs were taken throughout dissection. The intercostal nerves were involved on three occasions with dye, but not with latex. The lateral cutaneous branches of the intercostal nerve contained dye and latex on all occasions. The serratus plane block appears to be mediated through blockade of the lateral cutaneous branches of the intercostal nerves. Anatomically, serratus plane block does not appear to be equivalent to paravertebral block for rib fracture analgesia.
authors.affiliation: Newcastle University, Newcastle upon Tyne, UK.
authors.forename: J
authors.initials: J
authors.lastname: Mayes
authors.affiliation: Newcastle University, Newcastle upon Tyne, UK.
authors.forename: E
authors.initials: E
authors.lastname: Davison
authors.affiliation: Newcastle University, Newcastle upon Tyne, UK.
authors.forename: P
authors.initials: P
authors.lastname: Panahi
authors.affiliation: Newcastle University, Newcastle upon Tyne, UK.
authors.forename: D
authors.initials: D
authors.lastname: Patten
authors.affiliation: Northern Deanery, Newcastle upon Tyne, UK.
authors.forename: F
authors.initials: F
authors.lastname: Eljelani
authors.affiliation: Anaesthetic Department, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: J
authors.initials: J
authors.lastname: Womack
authors.affiliation: Anaesthetic Department, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
authors.forename: M
authors.initials: M
authors.lastname: Varma
mesh_terms: D002102:Cadaver; D006801:Humans; D007367:Intercostal Nerves / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D008751:Methylene Blue / Q000008:administration & dosage*; D009407:Nerve Block / Q000379:methods*; D035441:Thoracic Wall / Q000294:innervation*; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D008751:Methylene Blue
keywords: cadaveric dissection; plane block; serratus anterior