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A 42-year-old female was admitted with multiple fractured ribs after road traffic accident. She had severe pain which was managed initially with injectable NSAIDs, and Injection Tramadol. However, due to poor pain relief serratus plane block was given after informed consent. Under ultrasound guidance using high frequency linear probe (HFL-38, 13-6 MHz, Sono Site®) and using inline approach, 18G Tuohy needle was inserted at mid-axillary line (from posterior to anterior direction) either below or above the serratus anterior muscle (Figure 1 & 2) and catheter was inserted 3cm beyond needle tip. Position of needle and catheter were confirmed with injection of 2-5 ml saline. Both the catheters were secured over skin with an adhesive plaster (Figure 3) and were tagged to identify from outside.

Serratus Anterior Plane Block for Pain Relief in Multiple Fractured Ribs (MFRs); Injection of Local Anaesthetic above the Serratus or below the Serratus? - A Case Report