Ultrasound Guided Serratus Anterior Plane Block

Pathophysiology

Clinical assessment and risk stratification

Management (Performing the block)

4 Topics

Local anaesthetic dose

Superficial block

Pitfalls and Pearls

Ultrasound Guided Serratus Anterior Plane Block – Post Test

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Ultrasound Guided Serratus Anterior Plane Block – Post Test

Ultrasound Guided Serratus Anterior Plane Block Ultrasound Guided Serratus Anterior Plane Block – Post Test

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Question 1 of 8

1. Question
Which nerves are blocked by a successful SAPB?
- Intercostal nerves (lateral cutaneous branches), long thoracic nerve and thoracodorsal nerve
- Intercostal nerves (lateral cutaneous branches), short thoracic nerve and sympathetic chain
- Anterior ramus of spinal (intercostal) nerves, posterior ramus of spinal (intercostal) nerves, sympathetic chain and rami communicantes
- Anterior ramus of spinal (intercostal) nerves, posterior ramus of spinal (intercostal) nerves, sympathetic chain and long thoracic nerve
- Vagus nerve, spinal nerve roots and sympathetic chain
Question 2 of 8

2. Question
Which of the following is a contraindication to SAPB?
- Anti-coagulated patient
- Local infection over the injection area
- Pneumothorax on the side of the block
- Cervical-spine injury
- Transverse process fracture
Question 3 of 8

3. Question
Which of these patients has the clearest indication for SAPB?
- 35-year-old male with anterior lateral 3rd and 4th rib fractures, and a mild pain score on oral analgesia
- 35-year-old male with posterior 3rd and 4th rib fractures, and a mild pain score on oral analgesia
- 70-year-old male with right-sided anterior lateral 3rd, 4th and 5th rib fractures, and a severe pain score on intravenous analgesia
- 70-year-old male with right-sided posterior 3rd, 4th and 5th rib fractures, and a severe pain score on intravenous analgesia who is able to sit forward
- 21-year-old male with a simple pneumothorax requiring aspiration
Question 4 of 8

4. Question
Which of these is not a recognised complication of SAPB?
- Pneumothorax
- Vascular puncture
- Horner’s syndrome
- Failure or inadequate block
- Local anaesthetic toxicity
Question 5 of 8

5. Question
What is the typical ultrasound probe position for SAPB performance?
- 2nd intercostal space mid clavicular line
- 2cm lateral to the transverse process of the 5th thoracic vertebra
- At the level of the transverse process of the 5th thoracic vertebra
- 5th rib mid clavicular line
- 5th rib mid axillary line
Question 6 of 8

6. Question
In relation to serratus anterior…
- Latissimus dorsi lies inferior and pec major superior
- Erector spinae lies superior and the ribs and pleura lie inferior
- Latissimus dorsi lies superior and the ribs and pleura inferior
- Transverse abdominis lies inferior and rectus abdominis superior
- Internal oblique lies superior and external oblique inferior
Question 7 of 8

7. Question
Which artery is most commonly visible when performing SAPB?
- Axillary
- Superior thoracic
- Inferior thoracic
- Thoracodorsal
- Internal carotid
Question 8 of 8

8. Question
The maximum safe dose of levobupivacaine is?
- 0.5mg/kg
- 1mg/kg
- 1.5mg/kg
- 2mg/kg
- 2.5mg/kg

6 Comments

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Dr. Kashif Hussain November 23, 2021 at 11:43 am

good module

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Dr Steve Kulimushi December 14, 2021 at 7:35 am

well concise topic

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Dr Mohd Abdul Basith - December 16, 2023 at 1:02 pm

Excellent

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Dr Rashid Abdulla Mohamed Abuelhassan June 25, 2025 at 8:48 am

👌

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Dr Fatma Hassan ElBastwesy Aly October 20, 2025 at 5:05 am

Amazing

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Jan October 20, 2025 at 10:42 am

Interesting and well written
Thank you

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