• Tara Benesch, Daniel Mantuani, and Arun Nagdev.
• Highland General Hospital, Department of Emergency Medicine, Oakland, California.
• Clin Pract Cases Emerg Med. 2021 Feb 1; 5 (1): 117-120.

IntroductionThe serratus anterior plane block (SAPB) has been shown to effectively treat pain following breast surgery, thoracotomies, and rib fractures. We present the first reported case of a bilateral ultrasound-guided SAPB in a multimodal analgesic regimen after an acute large, thoracic, deep partial-thickness burn.Case ReportA 72-year-old male presented in severe pain two days after sustaining a deep partial- thickness burn to his anterior chest wall after his shirt caught on fire while cooking. The area of injury was on bilateral chest walls, and the patient was consented for bilateral SAPBs at the level of the third thoracic ribs (T3). With ultrasound guidance, a mixture of ropivacaine and lidocaine with epinephrine was injected into the fascial plane overlying bilateral serratus muscles at T3. The patient reported complete resolution of pain for approximately 15 hours and required minimal additional intravenous analgesia.ConclusionThe ultrasound-guided SAPB may be an excellent addition to the multimodal analgesic regimen in superficial and partial-thickness burns of the anterior chest wall.

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