Serratus Anterior Plane Block for Procedural Anesthesia for Pigtail Tube Thoracostomy: A Case Series
Introduction: Pneumothoraces are frequently treated by emergency physicians. Tube thoracostomy, the definitive treatment for a spontaneous pneumothorax, is associated with significant pain. Analgesia prior to tube thoracostomy often involves the administration of opioids and local infiltration of an...
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eScholarship Publishing, University of California
2025-01-01
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| Series: | Clinical Practice and Cases in Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/2bd7f94d |
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| author | Edward Lopez Raghav Sahni Maxwell Cooper Michael Shalaby |
| author_facet | Edward Lopez Raghav Sahni Maxwell Cooper Michael Shalaby |
| author_sort | Edward Lopez |
| collection | DOAJ |
| description | Introduction: Pneumothoraces are frequently treated by emergency physicians. Tube thoracostomy, the definitive treatment for a spontaneous pneumothorax, is associated with significant pain. Analgesia prior to tube thoracostomy often involves the administration of opioids and local infiltration of anesthetics. Thus far, regional anesthesia prior to pigtail tube thoracostomy in the emergency department (ED) has not been well described; it offers promise in alleviating pain associated with this procedure. Due to its ability to anesthetize all or most of the structures associated with tube thoracostomy—skin, serratus anterior muscles, intercostal muscles, and the parietal pleura—the serratus anterior plane block (SAPB) is a potentially promising fascial plane block prior to pigtail tube thoracostomy. Case Series: We present three cases of patients in the ED who received a SAPB and had nearly complete or complete anesthesia during pigtail tube thoracostomy. Conclusion: Pigtail tube thoracostomies are commonly performed in the ED and can be associated with significant pain despite a multimodal approach to pain management. The SAPB offers a safe and effective approach to anesthesia for patients in the ED undergoing a pigtail tube thoracostomy. |
| format | Article |
| id | doaj-art-a1a6ff2e168847c0a3c4c0d1d0739cb7 |
| institution | Kabale University |
| issn | 2474-252X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Clinical Practice and Cases in Emergency Medicine |
| spelling | doaj-art-a1a6ff2e168847c0a3c4c0d1d0739cb72025-02-04T17:35:19ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2025-01-01915910.5811/cpcem.21251cpcem-9-5Serratus Anterior Plane Block for Procedural Anesthesia for Pigtail Tube Thoracostomy: A Case SeriesEdward Lopez0Raghav Sahni1Maxwell Cooper2Michael Shalaby3Mount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, FloridaDrexel University College of Medicine, Department of Emergency Medicine, Philadelphia, PennsylvaniaDrexel University College of Medicine, Department of Emergency Ultrasound, Philadelphia, PennsylvaniaMount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, FloridaIntroduction: Pneumothoraces are frequently treated by emergency physicians. Tube thoracostomy, the definitive treatment for a spontaneous pneumothorax, is associated with significant pain. Analgesia prior to tube thoracostomy often involves the administration of opioids and local infiltration of anesthetics. Thus far, regional anesthesia prior to pigtail tube thoracostomy in the emergency department (ED) has not been well described; it offers promise in alleviating pain associated with this procedure. Due to its ability to anesthetize all or most of the structures associated with tube thoracostomy—skin, serratus anterior muscles, intercostal muscles, and the parietal pleura—the serratus anterior plane block (SAPB) is a potentially promising fascial plane block prior to pigtail tube thoracostomy. Case Series: We present three cases of patients in the ED who received a SAPB and had nearly complete or complete anesthesia during pigtail tube thoracostomy. Conclusion: Pigtail tube thoracostomies are commonly performed in the ED and can be associated with significant pain despite a multimodal approach to pain management. The SAPB offers a safe and effective approach to anesthesia for patients in the ED undergoing a pigtail tube thoracostomy.https://escholarship.org/uc/item/2bd7f94d |
| spellingShingle | Edward Lopez Raghav Sahni Maxwell Cooper Michael Shalaby Serratus Anterior Plane Block for Procedural Anesthesia for Pigtail Tube Thoracostomy: A Case Series Clinical Practice and Cases in Emergency Medicine |
| title | Serratus Anterior Plane Block for Procedural Anesthesia for Pigtail Tube Thoracostomy: A Case Series |
| title_full | Serratus Anterior Plane Block for Procedural Anesthesia for Pigtail Tube Thoracostomy: A Case Series |
| title_fullStr | Serratus Anterior Plane Block for Procedural Anesthesia for Pigtail Tube Thoracostomy: A Case Series |
| title_full_unstemmed | Serratus Anterior Plane Block for Procedural Anesthesia for Pigtail Tube Thoracostomy: A Case Series |
| title_short | Serratus Anterior Plane Block for Procedural Anesthesia for Pigtail Tube Thoracostomy: A Case Series |
| title_sort | serratus anterior plane block for procedural anesthesia for pigtail tube thoracostomy a case series |
| url | https://escholarship.org/uc/item/2bd7f94d |
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