Anesth Pain Med.  2022 Oct;17(4):434-438. 10.17085/apm.21120.

Serratus anterior plane block with ultrasound-guided hydrodissection for lateral thoracic pain caused by long thoracic nerve neuropathy – A case report -

• Kim M
• Goh D
• Cho S
• Noh Y
• Hwang B

• KMID: 2535343
• DOI: http://doi.org/10.17085/apm.21120

Abstract

Background
Long thoracic nerve (LTN) neuropathy occasionally occurs in young people who engage in various sports. It may have a traumatic or non-traumatic etiology. The landmark manifestation of LTN neuropathy is scapular winging; however, it can also occur without scapular winging and specific magnetic resonance imaging findings. Case: An 18-year-old male complained of right-sided lateral chest pain for 7 months. He was treated with medication, trigger point injection, and physical therapy but showed no improvement. Electromyelogram findings suggested LTN neuropathy in the right lateral chest. We performed a serratus anterior (SA) plane block with ultrasound (US)-guided hydrodissection and achieved pain relief.
Conclusions
We report the successful treatment of LTN neuropathy with an SA plane block and US-guided hydrodissection.

Keyword

Chest pain; Muscles; Nerve block; Nerve compression syndromes; Peripheral nerves; Ultrasonography

Figure

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  Fig. 1. Ultrasound image obtained during a serratus plane block and hydrodissection. The arrowheads indicate the direction of the needle. The needle is directed from the fourth rib to the fifth rib. The tip of the needle is above the serratus anterior muscle. Ld: latissimus dorsi muscle, SA: serratus anterior muscle, IC: intercostal muscle.

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