[Erector spinae plane block as a multiple catheter technique for open esophagectomy: a case report]

Alessandro De Cassai, Tommaso Tonetti, Helmut Galligioni, Carlo Ori, Alessandro De Cassai, Tommaso Tonetti, Helmut Galligioni, Carlo Ori

Abstract

Background and objective: Erector spinae plane block is a valid technique to provide simultaneously analgesia for combined thoracic and abdominal surgery.

Case report: A patient underwent open esophagectomy followed by reconstructive esophagogastroplasty but refused thoracic epidural analgesia; a multi-modal analgesia with a multiple erector spinae plane block was then planned. Three erector spinae plane catheters (T5 and T10 on the right side and T9 on the left side) for continuous analgesia were placed before surgery. During the first 48 h pain was never reported in the thoracic area but the patient reported multiple times to feel a pain well localized in epigastrium, but never localized in any other abdominal quadrant.

Discussion: Erector spinae plane block is a valid technique to provide analgesia simultaneously for combined thoracic and abdominal surgery and could be a valid alternative strategy if the use of epidural analgesia is contraindicated.

Keywords: Anestesia regional; Bloqueio do plano do eretor da espinha; Erector spinae plane block; Esofagectomia; Esophagectomy; Regional anesthesia.

Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Figures

Figure 1
Figure 1
Post-injection view showing transverse process (TP) and overlying layers of erector spinae muscle (ESM), rhomboid major muscle (RMM), and trapezius (TZ) and linear spread of local anesthetic (LA) in the muscular-fascial plane between erector spinae muscle and transverse process.
Figure 2
Figure 2
Abdominal T9 and T10 EPS block catheters.
Figure 3
Figure 3
Thoracic T5 EPS block catheter.

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Source: PubMed

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