{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:11:12Z","timestamp":1790226672811,"version":"4.1.0"},"reference-count":15,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2024,8,10]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Few cadaveric studies have evaluated the dye spread with superficial parasternal intercostal plane (SPIP) blocks. In this study, we examined the dye spread of an ultrasound-guided SPIP block in a human cadaveric model with single and double injection techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seven single and four double ultrasound-guided SPIP blocks were performed in seven unembalmed human cadavers using an in-plane approach with the transducer oriented parasagitally 1\u2009cm lateral to the sternum. For the single SPIP, 20\u2009mL of 0.166% methylene blue was injected in the second or third intercostal space into the plane between the Pec major muscle and internal intercostal muscles. For the double SPIP, 10\u2009mL of 0.166% methylene blue was injected in the SPIP at one intercostal space with an additional 10\u2009mL injected in the SPIP two intercostal spaces caudally. The extent of dye spread was documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For all SPIP injections, there was consistent mediolateral spread from the sternum to the mid-clavicular line, with many extending laterally to the anterior axillary line. There was craniocaudal spread to a median of 2 intercostal muscles with a single SPIP and 3 intercostal muscles with a double SPIP. There was a median spread to 1 intercostal nerve for the single SPIP and 1.5 intercostal nerves with the double SPIP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SPIP block demonstrated limited spread in this cadaver study. A single injection of this block may be of limited value and multiple SPIP injections may be needed to have adequate spread for anterior thoracic procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2024-105818","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T01:00:28Z","timestamp":1724288428000},"page":"948-952","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Anatomical evaluation of the superficial parasternal intercostal plane block"],"prefix":"10.1136","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4210-0942","authenticated-orcid":false,"given":"Monica","family":"Harbell","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A","family":"Nelson","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie R","family":"Langley","sequence":"additional","affiliation":[{"name":"Laboratory Medicine and Pathology, Mayo Clinic Arizona, Scottsdale, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David P","family":"Seamans","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Craner","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Phoenix, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,8,21]]},"reference":[{"key":"2025120505251978000_50.12.948.1","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1001\/jamasurg.2019.1153","article-title":"Guidelines for perioperative care in cardiac surgery: enhanced recovery after surgery society recommendations","volume":"154","author":"Engelman","year":"2019","journal-title":"JAMA Surg"},{"key":"2025120505251978000_50.12.948.2","doi-asserted-by":"crossref","first-page":"4173","DOI":"10.1053\/j.jvca.2022.07.025","article-title":"Parasternal intercostal nerve blocks in patients undergoing cardiac surgery: evidence update and technical considerations","volume":"36","author":"Schiavoni","year":"2022","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2025120505251978000_50.12.948.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2015.03.040"},{"key":"2025120505251978000_50.12.948.4","first-page":"460","article-title":"Current evidence of ultrasound guided fascial plane blocks for cardiac surgery: a narrative literature review","volume":"75","author":"Hong","year":"2022","journal-title":"Korean J Anesthesiol"},{"key":"2025120505251978000_50.12.948.5","doi-asserted-by":"crossref","first-page":"883","DOI":"10.1007\/s12630-024-02726-0","article-title":"Superficial parasternal intercostal plane blocks in cardiac surgery: a systematic review and meta-analysis","volume":"71","author":"Cameron","year":"2024","journal-title":"Can J Anaesth"},{"key":"2025120505251978000_50.12.948.6","doi-asserted-by":"publisher","DOI":"10.1053\/j.jvca.2023.11.038"},{"key":"2025120505251978000_50.12.948.7","doi-asserted-by":"crossref","DOI":"10.1080\/07853890.2024.2302983","article-title":"Preemptive deep parasternal intercostal plane block for perioperative analgesia in coronary artery bypass grafting with sternotomy: a randomized, observer-blind, controlled study","volume":"55","author":"Chen","year":"2023","journal-title":"Ann Med"},{"key":"2025120505251978000_50.12.948.8","doi-asserted-by":"crossref","first-page":"111430","DOI":"10.1016\/j.jclinane.2024.111430","article-title":"Efficacy of bilateral catheter superficial parasternal intercostal plane blocks using programmed intermittent bolus for opioid-sparing postoperative analgesia in cardiac surgery with sternotomy: A randomized, double-blind, placebo-controlled trial","volume":"95","author":"Li","year":"2024","journal-title":"J Clin Anesth"},{"key":"2025120505251978000_50.12.948.9","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1053\/j.jvca.2022.10.026","article-title":"An expert review of chest wall fascial plane blocks for cardiac surgery","volume":"37","author":"Hargrave","year":"2023","journal-title":"J Cardiothorac Vasc Anesth"},{"key":"2025120505251978000_50.12.948.10","doi-asserted-by":"crossref","DOI":"10.1186\/s44158-023-00134-2","article-title":"Which ultrasound-guided parasternal intercostal nerve block for post-sternotomy pain? Results from a prospective observational study","volume":"3","author":"Toscano","year":"2023","journal-title":"J Anesth Analg Crit Care"},{"key":"2025120505251978000_50.12.948.11","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2023-104716"},{"key":"2025120505251978000_50.12.948.12","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.23736\/S0375-9393.21.15599-3","article-title":"Ultrasound-guided parasternal blocks: techniques, clinical indications and future prospects","volume":"87","author":"Sepolvere","year":"2021","journal-title":"Minerva Anestesiol"},{"key":"2025120505251978000_50.12.948.13","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1016\/j.bja.2023.08.014","article-title":"Superficial versus deep parasternal intercostal plane blocks: cadaveric evaluation of injectate spread","volume":"132","author":"Douglas","year":"2024","journal-title":"Br J Anaesth"},{"key":"2025120505251978000_50.12.948.14","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2023-104595"},{"key":"2025120505251978000_50.12.948.15","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2019-100893"}],"container-title":["Regional Anesthesia &amp; Pain Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rapm-2024-105818","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T13:26:07Z","timestamp":1764941167000},"score":1,"resource":{"primary":{"URL":"https:\/\/rapm.bmj.com\/lookup\/doi\/10.1136\/rapm-2024-105818"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,21]]},"references-count":15,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,5]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/rapm-2024-105818"],"URL":"https:\/\/doi.org\/10.1136\/rapm-2024-105818","relation":{},"ISSN":["1098-7339","1532-8651"],"issn-type":[{"value":"1098-7339","type":"print"},{"value":"1532-8651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,21]]}}}