Erector spinae plane block: Relatively new block on horizon with a wide spectrum of application - A case series

Abstract

Erector spinae plane (ESP) block is an interfascial plane block where a local anaesthetic is injected in a plane preferably below the erector spinae muscle. It is supposed to work at the origin of spinal nerves based on cadaveric and contrast study. It has emerged as an effective and safe analgesic regional technique. It has a wide variety of applications ranging from control of acute postoperative pain to chronic pain. In this series, we report a series of six cases, which include postoperative pain management in breast, thoracic, and abdominal surgeries along with management of two chronic pain cases to illustrate the potential uses of continuous and single-shot ESP block.

Keywords: Analgesia; erector spinae block; regional.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1

Longitudinal view at transverse process. ST - subcutaneous tissue , 1 (TZ) - Trapezius, 2(RM) - Rhomboid Major, 3(ES) - Erector Spinae, 4 - Transverse process, [S] - Superficial needle approach, [D] - Deep needle approach

Figure 2

(a) Longitudinal view at transverse process 1 – trapezius, 2 – rhomboid major,3- erector spinae,4- transverse process, 5- external intercostal muscles, 6- internal intercostal muscle, 7 – paravertebral space , 8- pleura. (b) longitudinal view at ribs 1 – trapezius, 2 – rhomboid major,3- erector spinae, 4- RIB,5- intercostal muscles, 6 - pleura. (c) Linear visible pattern while lifting the muscle. (d) Epidural catheter insertion

Figure 3

Dermatomes covered with different site used for erector spinae plane block in different cases

Figure 4

Longitudinal view at transverse process. 1- Trapezius , 2 - Rhomboid Major , 3 - Erector Spinae , 4 - drug ( single arrow), 5 - Transverse process