[Serratus-Intercostal Plane Block for Brest Surgery]

Background: Serratus-intercostal plane block (SIPB) is a novel ultrasound-guided thoracic wall nerve block reported recently. We performed SIPB for perioperative analgesia together with general anesthesia in patients undergoing partial mastectomy.

Methods: We chose the patients with breast cancer of upper to lower lateral quadrant or subareolar region. The patients received general anesthesia followed by ultrasound-guided SIPB. The needle was introduced in the midaxillary line at the level of the fourth or fifth rib. Under continuous ultrasound guidance, we injected 30 ml of ropivacaine 0.375-0.5% between the serratus anterior and the external intercostal muscles.

Results: After the partial mastectomy, the area of sensory loss obtained by skin prick was extended from five to six as the number of intercostal spaces. Analgesic effect was obtained for 12 to 24 hours. The cephalad dermatomal paresthesia was T2. More than 20 patients received SIPB, and no one acquired the sensory loss at T1 of dermatomal distribution.

Conclusions: SIPB provides effective analgesia for breast surgery of upper to lower lateral quadrant and/or subareolar region. However, it should be administered with other additional analgesic agents when axillary dissection is performed, because sensory loss of T1 is difficult to achieve.