Serratus Anterior Plane Block

Quick review of Serratus Anterior Plane Block with examples.
Pic Courtesy - Dr Arun Nagdev and HighlandUltrasound.com
Other useful Thoracic blocks :
Erector Spinae Block - • Erector Spinae Plane B...
Parasternal Block - • Parasternal Block

[@arunabhakarmakar5644]

Thank you, this was very educational. Will you also cover the other blocks?

[@hocuspocus3797]

There are a few more blocks explained on the channel. What block would you like to see next?

[@arunabhakarmakar5644]

I see you have covered a few more blocks. Maybe having the common upper and lower limb and truncal and abdominal blocks should be good.

[@doc4804]

What concentration of LA do you utilize? Adjunct with Decadron?

[@hocuspocus3797]

Usually we use 0.25% Levobupivacaine for boluses and 0.125% levobupivacaine for infusion. Some of us do use an adjunct but I mostly just stick to long acting LA.

[@ParagMathurmd]

What are your standards for anticoagulation? Will you block a patient on Plavix for instance?

[@hocuspocus3797]

SAP block is considered a superficial block. It is a low risk procedure with risk slightly higher than local infiltration of LA but way less than deeper blocks or neuraxial blocks. Generally I would block patients on anti-platelets and even anticoags unless very overtly coagulopathic. Would make sure I have localized and visualized vessels in needle path like the thoraco-dorsal artery.
However I would recommend following local guidelines or regional guidelines.

[@edwardherrera846]

La-Tis-A-Miss-Door-Sai
Fa-Shull-Plane
Tho-Racko-Door-Sul
Fa-Sha