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Combined Superficial and Deep Serratus Plane Block With Bupivacaine, Dexamethasone, and Clonidine in the Treatment of a Patient With Postmastectomy Pain Syndrome

A Case Report

Maranto, Christopher J., MD; Strickland, Natalie R., MD; Goree, Johnathan H., MD

doi: 10.1213/XAA.0000000000000792
Case Reports

Postmastectomy pain syndrome poses a significant treatment challenge. We present the case of a 42-year-old woman who presented to our pain clinic with a 16-month history of postmastectomy pain. We performed a combined superficial and deep serratus plane block using bupivacaine, dexamethasone, and clonidine. At 1-month follow-up, the patient had 100% pain relief. At 2-month follow-up, her pain was 5/10. The block was repeated with the same drugs at 3 months with similar pain relief. This case illustrates the utility of a combined superficial and deep serratus plane block in postmastectomy pain syndrome with a possible benefit from added dexamethasone and clonidine.

From the University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Accepted for publication April 3, 2018.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Christopher J. Maranto, MD, Department of Anesthesiology, University of Arkansas for Medical Sciences, 4301 W Markham St, #515, Little Rock, AR 72205. Address e-mail to

© 2018 International Anesthesia Research Society
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