Ultrasound-guided Erector Spinae Plane Block: Indications, Complications, and Effects on Acute and Chronic Pain Based on a Single-center Experience

Serkan Tulgar, Onur Selvi, Ozgur Senturk, Talat E Serifsoy, David T Thomas, Serkan Tulgar, Onur Selvi, Ozgur Senturk, Talat E Serifsoy, David T Thomas

Abstract

Introduction: Erector spinae plane block (ESPB) is a novel regional anesthesia technique used in postoperative pain and chronic neuropathic pain of the thoracoabdominal region. There are no previously published large case series. This retrospective review aimed to report the indications, levels of block, success of block and complications, and also to evaluate the effect of ESPB on postoperative/chronic pain.

Methods: We retrospectively evaluated the charts and medical records of 182 patients who had ESPB in the last one year. All records were collected in the postoperative recovery room, ward, and pain unit.

Results: ESPB performed at several different levels and for several different indications led to effective postoperative analgesia when part of a multimodal analgesia plan. Few complications were noted.

Conclusion: ESPB is an interfascial plane block with many indications. The possibility of complications must be considered.

Keywords: erector spinae block; erector spinae plane block; espb; pain; regional anesthesia.

Conflict of interest statement

The authors have declared that no competing interests exist.

References

    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 at L-4 transverse process level provides effective postoperative analgesia for total hip arthroplasty. Tulgar S, Senturk O. J Clin Anesth. 2018;44:68.
    1. Aksu C, Gürkan Y. Anaesth Crit Care Pain Med. 6; Available: [In Press] 2018. Ultrasound-guided bilateral erector spinae plane block could provide effective postoperative analgesia in laparoscopic cholecystectomy in paediatric patients.
    1. Ultrasound guided low thoracic erector spinae plane block for postoperative analgesia in radical retropubic prostatectomy, a new indication. Tulgar S, Senturk O. J Clin Anesth. 2018;47:4.
    1. Evaluation of ultrasound-guided erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: a prospective, randomized, controlled clinical trial. Tulgar S, Kapakli MS, Senturk O, Selvi O, Serifsoy TE, Ozer Z. J Clin Anesth. 2018;49:101–106.
    1. Ultrasound guided erector spinae plane block reduces postoperative opioid consumption following breast surgery: a randomized controlled study. Gürkan Y, Aksu C, Kuş A, Yörükoğlu UH, Kılıç CT. J Clin Anesth. 2018;50:65–68.
    1. Bilateral erector spinae plane block for acute post-surgical pain in adult cardiac surgical patients: a randomized controlled trial. Krishna SN, Chauhan S, Bhoi D, Kaushal B, Hasija S, Sangdup T, Bisoi AK. J Cardiothorac Vasc Anesth. [In Press] 2018
    1. Pneumothorax following erector spinae plane block. Hamilton DL. J Clin Anesth. 2018;25:17.
    1. Selvi O, Tulgar S. Rev Esp Anestesiol Reanim. Vol. 65. 9; Available: 2018. Ultrasound guided erector spinae plane block as a cause of unintended motor block. [Article in English, Spanish] pp. 589–592.
    1. The erector spinae plane (ESP) block: a pooled review of 242 cases. Tsui BCH, Fonseca A, Munshey F, McFadyen G, Caruso TJ. J Clin Anesth. 2019;53:29–34.
    1. Ivanusic J, Konishi Y, Barrington MJ. Reg Anesth Pain Med. Vol. 43. 10; Available: 2018. A cadaveric study investigating the mechanism of action of erector spinae blockade; pp. 567–571.
    1. Adhikary SD, Bernard S, Lopez H, Chin KJ. Reg Anesth Pain Med. Vol. 43. 23; Available: 2018. Erector spinae plane block versus retrolaminar block: a magnetic resonance imaging and anatomical study; pp. 756–762.
    1. Vidal E, Giménez H, Forero M, Fajardo M. Rev Esp Anestesiol Reanim. Vol. 65. 27; Available: 2018. Erector spinae plane block: a cadaver study to determine its mechanism of action. [Article in English, Spanish] pp. 514–519.
    1. Lumbar versus thoracic erector spinae plane block: similar nomenclature, different mechanism of action. Kose HC, Kose SG, Thomas DT. J Clin Anesth. 2018;48:1.
    1. Reply to Dr. Ueshima: the relationship of local anesthetic volume and dermatomal spread of sensorial block in erector spinae plane blocks: a new dilemma. Tulgar S, Ahiskalioglu A, Balaban O. J Clin Anesth. 2019;52:57.
    1. Erector spinae block. A narrative review. López MB, Cadórniga ÁG, González JML, Suárez ED, Carballo CL, Sobrino FP. Central Eur J Clin Res. 2018;1:28–39.
    1. Local anesthetic spread during erector spinae plane block. De Cassai A, Tonetti T. J Clin Anesth. 2018;48:60–61.
    1. Erector spinae block at L2 for thigh lift surgery, a new application. Goodman DA. J Clin Anesth. 2019;52:82.
    1. Erector spinae plane block for pain management of wide post-herpetic neuralgia. Ueshima H, Otake H. J Clin Anesth. 2018;51:37.
    1. Reply to Goodman: lumbar erector spinae plane block for thigh lift surgery: which level, which block and which procedure? Aygun H, Thomas DT, Tulgar S. J Clin Anesth. 2019;53:75.
    1. Interfascial plane blocks: back to basics. Elsharkawy H, Pawa A, Mariano ER. Reg Anesth Pain Med. 2018;43:341–346.
    1. Clinical experiences of ultrasound-guided lumbar erector spinae plane block for hip joint and proximal femur surgeries. Tulgar S, Selvi O, Senturk O, Ermis MN, Cubuk R, Ozer Z. J Clin Anesth. 2018;47:5–6.
    1. Local anesthetic systemic toxicity: continuing professional development. El-Boghdadly K, Chin KJ. Can J Anaesth. 2016;63:330–349.
    1. Local anesthetic systemic toxicity: current perspectives. El-Boghdadly K, Pawa A, Chin KJ. Local Reg Anesth. 2018;8:35–44.
    1. Ultrasound guidance reduces the risk of local anesthetic systemic toxicity following peripheral nerve blockade. Barrington MJ, Kluger R. Reg Anesth Pain Med. 2013;38:289–299.
    1. Transversus abdominis plane block in lower segment cesarean section: a question of block failure or lack of efficacy? Factor D, Chin KJ. Reg Anesth Pain Med. 2010;35:404–405.
    1. Duration of analgesic effectiveness after the posterior and lateral transversus abdominis plane block techniques for transverse lower abdominal incisions: a meta-analysis. Abdallah FW, Laffey JG, Halpern SH, Brull R. Br J Anaesth. 2013;111:721–735.
    1. Spread of local anesthetic solution in the erector spinae plane block. Ueshima H, Otake H. J Clin Anesth. 2018;45:23.
    1. The erector spinae plane block provides visceral abdominal analgesia in bariatric surgery: a report of 3 cases. Chin KJ, Malhas L, Perlas A. Reg Anesth Pain Med. 2017;42:372–376.
    1. Erector spinae plane block for different laparoscopic abdominal surgeries: case series. Tulgar S, Selvi O, Kapakli MS. Case Rep Anesthesiol. 2018;18:3947281.

Source: PubMed

3
Abonnere