The tissue plane deep to the rhomboid extend medially deep director and laterally deep to the serratus anterior. The tissue plane deep to the serratus extend medially deep to the erector spinae.
Please a linear transducer in transverse orientation over the medial border of the scapula. Then rotate the ultrasound probe 90 degree to the sagittal plane.
Advance the needle in plane through the trapezius and rhomboids in a cranial caudal direction. Then inject 10 to 20 ml of local anaesthetic in the facial plane between rhomboid and the intercostal muscles and ribs.
Then advance the needle in plane directed caudally and laterally. Inject 10 to 12 ml of local anaesthetic in the tissue plane between the serratus anterior, and external intercostal muscle and ribs. The local anaesthetic spread deep to the serratus anterior muscle cranial caudally and spread laterally targets the lateral cutaneous branches and spread medially deep to the erector spinae muscle.