Rhomboid Intercostal and Subserratus Plane Block: A Cadaveric and Clinical Evaluation

Regional Anesthesia and Pain Medicine
Hesham ElsharkawyNabil Elkassabany

Abstract

Fascial plane blocks are rapidly emerging to provide safe, feasible alternatives to epidural analgesia for thoracic and abdominal pain. We define a new option for chest wall and upper abdominal analgesia, termed the rhomboid intercostal and subserratus plane (RISS) block. The RISS tissue plane extends deep to the erector spinae muscle medially and deep to the serratus anterior muscle laterally. We describe a 2-part proof-of-concept study to validate the RISS block, including a cadaveric study to evaluate injectate spread and a retrospective case series to assess dermatomal coverage and analgesic efficacy. For the cadaveric portion of the study, bilateral ultrasound-guided RISS blocks were performed on 6 fresh cadavers with 30 mL of 0.5% methylcellulose with india ink. For the retrospective case series, we present 15 patients who underwent RISS block or RISS catheter insertion for heterogeneous indications including abdominal surgery, rib fractures, chest tube-associated pain, or postoperative incisional chest wall pain. In the cadaveric specimens, we identified staining of the lateral branches of the intercostal nerves from T3 to T9 reaching the posterior primary rami deep to the erector spinae muscle medially. In the clinical ...Continue Reading

Citations

Jan 13, 2019·Regional Anesthesia and Pain Medicine·Duncan Lee HamiltonEiman Abdel Meguid
May 16, 2019·The Korean Journal of Pain·Korgün Ökmen
Mar 20, 2019·Korean journal of anesthesiology·Pablo KotJose De Andrés
Apr 24, 2020·Regional Anesthesia and Pain Medicine·Hesham ElsharkawyBan C H Tsui
Feb 13, 2020·Korean journal of anesthesiology·Hesham ElsharkawyRodney A Gabriel
Nov 19, 2020·Regional Anesthesia and Pain Medicine·Carlos Rodrigues Almeida
Jun 20, 2021·Regional Anesthesia and Pain Medicine·Ki Jinn ChinMiguel A Reina
Jun 20, 2021·Regional Anesthesia and Pain Medicine·David H KimStavros G Memtsoudis
Oct 15, 2021·Scandinavian Journal of Pain·Cristiano D'ErricoAntonio Frangiosa

❮ Previous
Next ❯

Related Concepts

Related Feeds

Aphasia

Aphasia affects the ability to process language, including formulation and comprehension of language and speech, as well as the ability to read or write. Here is the latest research on aphasia.