Low-dose dexmedetomidine as adjuvant to serratus anterior plane block for chest trauma in critically ill patient: Three case reports
Francesca De Sanctis1
, Ezio Amorizzo2, Gian Marco Petroni1, Luciano Giacomino1, Giuseppe Fratini1, Bruno Coccetti3, Rita Commissari1, Pierfrancesco Fusco4
1Department of Anesthesia, Critical Care and Pain Medicine, Az. Osp. S. Maria Terni, Italy
2Pain Unit, San Paolo Hospital Civitavecchia, Italy
3Department of Anesthesia, Critical Care and Pain Medicine, S. Camillo de Lellis Rieti, Italy
4Departmen of Intensive Care Unit, Department of Anesthesiology, S. Filippo e Nicola Hospital, Avezzano, L’Aquila, Italy
Keywords: Chest trauma, intensive care unit patient, locoregional anesthesia, multimodal analgesia, polytraumatized, rib fractures, serratus anterior plane block.
Abstract
Serratus anterior plane block (SAPB) is an effective regional anesthesia technique for chest wall analgesia. In this article, we report three cases of critically ill patients with chest trauma in whom a single-shot SAPB combined with low-dose dexmedetomidine (DEX) was used as part of a multimodal analgesia strategy. In all cases, SAPB with DEX provided effective and prolonged analgesia, with pain relief lasting up to 72 hours. The technique also contributed to improved respiratory function and facilitated clinical decision-making during the weaning process in one patient by helping to distinguish pain-related respiratory limitation from diaphragmatic dysfunction. In conclusion, SAPB with low-dose DEX may be a safe and effective option for chest wall analgesia at T3-T8 levels, even in polytrauma patients.
Cite this article as: De Sanctis F, Amorizzo E, Petroni GM, Giacomino L, Fratini G, Coccetti B, et al. Low-dose dexmedetomidine as adjuvant to serratus anterior plane block for chest trauma in critically ill patient: Three case reports. Agri 2026;38(2):130-133. doi: 10.5606/agri.2026.45.