Ultrasound-Guided Serratus Anterior Plane Block for Acute Pain Management in Emergency Medicine: A Systematic Review.

Background: Use of the serratus anterior plane block (SAPB) by emergency physicians is increasing. Clinical evidence supporting its utility in the emergency department (ED) is limited and has not been comprehensively summarized.

Objective: The aim of this review was to summarize and evaluate the utility of ultrasound-guided SAPBs performed by emergency physicians for acute pain management in the ED.

Methods: Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic literature search of the PubMed, Scopus, and Cochrane databases was performed from database inception to October 2023. Published articles reporting on SAPBs performed by emergency physicians were reviewed and qualitatively summarized.

Results: Fourteen articles reporting on 81 patients were identified, among which SAPBs were performed by emergency physicians for five separate indications, including rib fracture, tube thoracostomy, acute herpes zoster, chest wall burns, and unspecified chest wall injury. Overall, SAPBs performed by emergency physicians were associated with improvements in subjective and objective measures of pain, and no complications were reported following the blocks.

Conclusions: The SAPB performed by trained emergency physicians may be a reasonable analgesia strategy for managing several causes of acute chest wall pain in the ED, though evidence to date is limited and further higher quality research is needed.