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Area of Science:

  • Anesthesiology
  • Anatomy
  • Regional Anesthesia

Background:

  • Serratus plane block offers analgesia for breast and thoracic surgeries.
  • Optimal techniques for consistent serratus plane block success require further study.

Purpose of the Study:

  • Evaluate how injection volume, level, and site impact injectate spread.
  • Determine factors influencing anesthetic coverage in serratus plane blocks.

Main Methods:

  • Ultrasound-guided methylene blue dye injection in 39 cadaveric hemithoraces.
  • Four protocols tested: 20mL superficial/deep to serratus anterior muscle (SAM) at 5th rib, or 40mL (two 20mL injections) superior/deep to SAM at 3rd and 5th ribs.
  • Dissection and 3D digitization mapped dye spread.

Main Results:

  • Injectate spread extent primarily influenced by injection volume, not plane (superficial vs. deep to SAM).
  • Increasing volume from 20mL to 40mL doubled spread area, favoring anterior chest wall distribution.
  • Axillary dye presence was most consistent with a separate injection at the third rib level.

Conclusions:

  • High-volume, double-injection serratus plane block techniques ensure extensive anterior chest wall and axillary spread.
  • This method offers potentially more reliable analgesia for breast and axillary surgeries.
  • Further clinical studies are needed to confirm efficacy.