Place the probe in the parasagittal plane on the midclavicular line and the fifth rib is identified by counting from above. The rib is tracked to the midaxillary line. Rotate the probe 45 degrees from the axial plane.
The latissimus dorsi, the serratus anterior and the teres major muscles are overlying the fifth rib (see previous page). The thoracodorsal artery can be used as a marker of the fascial plane between the latissimus dorsi and serratus anterior muscles.
The needle is inserted from the anterior end of the probe and advanced in-plane
Inject 25 mL ropivacain 0.2% into the fascial plane between the serratus anterior and latissimus dorsi muscles
The upper image shows the position of the probe and the in-plane needle orientation. The lower image shows the fascial plane between the latissimus dorsi m. (blue asterix) and the serratus anterior m. (red asterix). Cr (cranial); Ca (caudad); r3-r5 (ribs 3-5); teres major m. (green asterix). The needle is displayed (magenta).
