Korean J Anesthesiol.  2020 Dec;73(6):550-556. 10.4097/kja.19479.

Rhomboid intercostal and subserratus plane block -a case series-

  • 1Department of Outcomes Research Anesthesiology Institute, Cleveland Clinic, Cleveland, OH, USA
  • 2Case Western University, MetroHealth Campus, Cleveland, OH, USA
  • 3Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpaşa, Cerrahpasa Medical Faculty, Istanbul, Turkey
  • 4Department of Anesthesiology, University of California, San Diego, San Diego, CA, USA


The rhomboid intercostal and subserratus plane (RISS) block is a new interfascial block technique that has shown promising results for abdominal and thoracic surgeries. Our objective was to describe the improved analgesia and dermatomal coverage in patients who received bilateral RISS blocks after a major abdominal surgery. Case: Twenty-one patients who underwent abdominal surgery received the rhomboid intercostal component of the block at the T5 to T6 levels, and the subserratus component block was performed at the T6 to T9 levels.The RISS blocks provided effective postoperative analgesia. There was a variation in the dermatomal coverage ranging from T3 to T12. Patients reported a high satisfaction rate from pain management.
The RISS block in abdominal surgery seems to have an important role in perioperative pain management, complementing the multimodal analgesic regimen. To determine the efficacy of the RISS block for abdominal surgery, we need further randomized control trials.


Acute pain; Abdominal surgery; Interfacial blocks; Postoperative pain; Rhomboid intercostal and subserratus plane (RISS) block; Truncal blocks; Ultrasound in pain medicine
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