Spread of Injectate After Combined Deep Serratus Anterior and Superficial Parasternal Intercostal Plane Injections: A Cadaver Study to Evaluate Their Utility in Breast Surgery
Authors' conclusion
This study demonstrated extensive spread of dye injectate with combined PIP and SAP injections involving anterior and lateral cutaneous branches of intercostal nerves and lateral and medial pectoral nerves.
Study context
- Population
- Cadaveric hemithoraces
- Participants
- 18 hemithoraces
- Comparison
- Parasternal intercostal plane (PIP) vs serratus anterior plane (SAP)
- Outcome
- Staining of intercostal nerves (number of intercostal spaces and nerves stained)
- Follow-up
- 15 min post-injection
Methodological detailsultrasound-guided dye injections
- Ultrasound-guided dye injections
Main finding
As reported in the abstract
Injectate spread
- PIP: cranial spread up to 2nd intercostal nerve incl. anterior cutaneous branch
- 14/16 (87.5%)
- PIP: caudal spread to 5th intercostal nerve
- 15/16 (94%)
- PIP: staining of medial and lateral pectoral nerves
- 14/16 (88%)
- SAP: cranial spread up to lateral cutaneous branch of 3rd intercostal nerve
- 9/16 (56%)
- SAP: caudal spread up to lateral cutaneous branch of 6th intercostal nerve
- 14/16 (88%)
Original publication
Spread of Injectate After Combined Deep Serratus Anterior and Superficial Parasternal Intercostal Plane Injections: A Cadaver Study to Evaluate Their Utility in Breast Surgery. Acta Anaesthesiol Scand. Published 14 October 2025. doi:10.
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