Serratus Anterior Plane Block

This Video was filmed by GE Healthcare during a live demo given by Dr Pawa at their booth during an international conference.
In this video - Dr Pawa is talking about approaches to the serratus anterior plane block

[@SamtaniPradeep]

Thank you Sir, for changing my scanning approach to your posterior to anterior transverse scanning approach

[@DrAmitPawa]

Welcome!

[@user-sb8zr7xk3t]

Amazing video D.Pawa

[@DrAmitPawa]

Many thanks once again! Please do share and encourage others to subscribe too!

[@user-up8cp4fg9u]

chapeau 👏👏👏👏

[@DrAmitPawa]

Thank you!

[@MrGamal58e]

Again thank you.two more questions. First can we do SAP block at T2-T3 level to cover T2 intercostal nerve so that give analgesia to axillary.second what's best block that cover modified radical mastectomy? Can SAP block with ESP at T2 level do the job?

[@DrAmitPawa]

Thanks for comment and liking/subscription
We can do a Pectoserratus block to aim to get T2 for sure, but there are other options such as at the conjoint tendon in axilla
My preference for Modified Radical mastectomy is Paravertebral plus Pectoserratus/Interpectoral block, but your suggestion would also be good.

[@zakalobi80]

Can I ask, do you inject at Level of 5th rib?, and what's your recommended way to identify that level?

[@DrAmitPawa]

I vary my injection depending on target area, but oftentimes yes, the fifth rib. I count down from infraclavicular region identifying 1st rib very medial on chest, and then move probe down and lateral, counting as i go

[@zakalobi80]

@@DrAmitPawa thank you, sir.

[@SamtaniPradeep]

Sir can you explain in difference in nerves blocked in superficial and deep SAP block??

[@DrAmitPawa]

Nerves the same. Just different end points.

[@MrGamal58e]

Thanks. First can we give SAP block at T7 for upper abdominal surgery?

[@DrAmitPawa]

Thanks. You would be better off doing sub-costal TAP, or External Oblique Intercostal block for this indication academic.oup.com/painmedicine/article-abstract/22/11/2436/6385251

[@aliahiskalioglu]

External oblique intercostal fascial plane block is more suitable

[@DrAmitPawa]

@@aliahiskalioglu absolutely! Agree and mentioned this in reply to original comment.