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Background and Aims Ultrasound-guided Serratus posterior superior intercostal plane (SPSIP) block is a newly defined interfascial plane block and targets the shoulder and hemithorax. Ultrasound-guided Serratsu posterior superior plane (SPSIP) block is a newly defined interfascial plane block and targets the shoulder and hemithorax. Extensive spread was reported from C7 to T7 in the cadaveric study, and from C3 to T10 in clinical applications . Herein, we report our SPSIP block and first catheterization in a critical patient.
Methods A 48-year-old male patient presented with a fall, resulting in fractures of the left scapula, radius, pelvis, and acetabulum, along with multiple rib fractures and a pneumothorax.He had severe pain due to scapula and rib fractures, thoracic tube, and began to desaturate (88-90%) because he had difficulty in breathing deeply and atelectasis was developing.
Results Despite routine analgesia, the patient started to deteriorate and left SPSIP block was applied with 40 mL of local anesthetic. Despite routine analgesia, the patient started to deteriorate and left SPSIP block was applied with 40 mL of local anesthetic. When asked about the patient‘s pain originating from the shoulder and thorax, he reported that his NRS decreased from 9 to 2. The next day, a catheter was inserted in the same plane. 20 ml of contrast was administered, allowing determination of the contrast spread from T1 to T4, reaching up to the anterior axillary line (figure 1).
Conclusions Ultrasound-guided SPSIP block can effectively alleviate pain in the shoulder and hemithorax and may be beneficial in patients with scapula and rib fractures.
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