Erector Spinae Plane Block for the Treatment of Post Mastectomy Pain Syndrome

Jamal Hasoon, Ivan Urits, Omar Viswanath, Bilal Dar, Alan D Kaye, Jamal Hasoon, Ivan Urits, Omar Viswanath, Bilal Dar, Alan D Kaye

Abstract

Postmastectomy pain syndrome (PMPS) is a common complication after breast cancer surgery and is often challenging to manage. Treatment options include medication management, physical therapy, and interventional procedures. The erector spinae plane block (ESPB) is a regional technique proven to help both acute postoperative analgesia and chronic neuropathic pain conditions. This block is becoming more popular in the chronic pain setting for neuropathic thoracic pain conditions. We describe the utilization of the ESP block for significant neuropathic breast pain after total mastectomy. Our case demonstrates the utility of this block for women suffering from severe PMPS.

Keywords: breast surgery; chronic pain; erector spinae plane block; post mastectomy pain syndrome.

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2021, Hasoon et al.

Figures

Figure 1. Erector spinae plane block with…
Figure 1. Erector spinae plane block with fluoroscopic guidance
Fluoroscopy was used to confirm the correct level for the block. The red arrow is pointing towards the transverse process, which is the target for this block.

References

    1. A systematic review of therapeutic interventions to reduce acute and chronic post-surgical pain after amputation, thoracotomy or mastectomy. Humble SR, Dalton AJ, Li L. Eur J Pain. 2015;19:451–465.
    1. Prevalence of post-mastectomy pain syndrome and associated risk factors: a cross-sectional cohort study. Couceiro TC, Valença MM, Raposo MC, Orange FA, Amorim MM. Pain Manag Nurs. 2014;15:731–737.
    1. Neural blockade for persistent pain after breast cancer surgery. Wijayasinghe N, Andersen KG, Kehlet H. Reg Anesth Pain Med. 2014;39:272–278.
    1. Ultrasound-guided serratus plane block for treatment of postmastectomy pain syndromes in breast cancer patients: a case series. Zocca JA, Chen GH, Puttanniah VG, Hung JC, Gulati A. Pain Pract. 2017;17:141–146.
    1. Continuous erector spinae plane block for thoracotomy analgesia after epidural failure. Raft J, Chin KJ, Belanger ME, Clairoux A, Richebé P, Brulotte V. J Clin Anesth. 2019;54:132–133.
    1. A cadaveric study investigating the mechanism of action of erector spinae blockade. Ivanusic J, Konishi Y, Barrington MJ. Reg Anesth Pain Med. 2018;43:567–571.
    1. Erector spinae plane block for relief of chronic intercostal neuralgia after chest tube placement. Hasoon J, Al-Jumah R, Aner M. Anaesthesiol Intensive Ther. 2020;52:350–351.
    1. Expanding role of the erector spinae plane block for postoperative and chronic pain management. Urits I, Charipova K, Gress K, Laughlin P, Orhurhu V, Kaye AD, Viswanath O. Curr Pain Headache Rep. 2019;1:71.
    1. Utilization of erector spinae plane block in the chronic pain clinic for two patients with post-thoracotomy pain. Hasoon J, Urits I, Viswanath O, Aner M. Cureus. 2020;3:8988.
    1. The erector spinae plane block a novel analgesic technique in thoracic neuropathic pain. Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. Reg Anesth Pain Med. 2016;41:621–627.
    1. Ultrasound-guided erector spinae plane block: indications, complications, and effects on acute and chronic pain based on a single-center experience. Tulgar S, Selvi O, Senturk O, Serifsoy TE, Thomas DT. Cureus. 2019;11:3815.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit