Erector Spinae Plane Block at the Lower Thoracic Level for Postoperative Pain Management After Spinal Cord Stimulation Implantation

Chung, Kyudon; Kim, Eung Don

doi:10.1093/pm/pny076

Cited by 3 publications

(9 citation statements)

References 9 publications

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“…33 34 In all the studies mentioned earlier, the method included leaving catheters between the transverse processes and the interfascial erector plane to allow for periodic boluses of anaesthetics. 27 28 29 30 31 32 33 34…”

Section: Discussionmentioning

confidence: 99%

“…For this, a universallyconducted protocol was used involving both L4 transverse processes. [27][28][29][30][31][32][33][34][35] Later, a 19-or 21-gauge spinal needle is introduced in a cephalocaudal direction, 4 to 5cm from the midline, until it reaches the tip of the transverse process of L4 bilaterally. After the needle contacts the bone, hydrodissection is performed using 3mL of saline solution mixed with 2cm of contrast material to confirm the location of the needle in the interfascial plane of the spinal erector muscles.…”

Section: Bilateral Erector Spinae Plane Block (Esp Block)mentioning

confidence: 99%

“…This implies cephalocaudal spread of the analgesic four to six vertebral levels in either direction. [27][28][29][30][31][32][33][34][35][36][37] In our study, we used the ESP block only once after surgery in each patient. We did not use continuous infusion catheters.…”

Section: Bilateral Erector Spinae Plane Block (Esp Block)mentioning

confidence: 99%

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Bilateral Radioscopically Guided Erector Spinae Plane Block for Postoperative Analgesia in Spine Surgery: A Randomized Clinical Trial

Beltrame

Fasano

Jalón

2022

J Neurol Surg A Cent Eur Neurosurg

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Study design: Randomized clinical trial. Objectives: To compare two perioperative pain management procedures: a radioscopically-guided erector spinae plane (ESP) block versus the standard wound infiltration technique with local anaesthetics, in patients undergoing lumbosacral spine surgery. Methods: A randomized, double-blind clinical trial was performed, in which adults at our hospital undergoing lumbosacral surgery without fixation were randomly assigned to receive either the standard wound infiltration technique, employing long-term anaesthetics, or a radioscopically-guided ESP block. Postoperative pain severity, morphine consumption, number of patients immobilised due to wound pain, length of hospitalisation, and complications were recorded. Results: Over the first seven postoperative hours, pain relief was superior in the ESP block group among patients who underwent discectomies or one-level decompression (p<0.0001). Using an ESP block also was statistically superior at decreasing all postoperative variables recorded in patients scheduled for multi-level decompression: VAS pain severity over the first seven hours after the procedure (p=0,0004); number of patients with wound pain 1 (p=0.049), 7 (p<0.0001) and 24 hours (p=0.007) after surgery; length of hospitalisation (p=0.0007), number of patients immobilised for wound pain (p=0.0004) and rescue morphine consumption (p<0.0001). Conclusion: The ESP block is a safe procedure which seems to outperform the infiltration wound technique for postoperative pain management in patients undergoing open spinal surgery. Future studies are needed to verify its effectiveness for arthrodesis/fixation and minimally-invasive procedures, and for chronic spine pain relief. Keywords: erector muscles - spinal surgery - postoperative analgesia -nerve block

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Section: Discussionmentioning

confidence: 99%

Section: Bilateral Erector Spinae Plane Block (Esp Block)mentioning

confidence: 99%

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Bilateral Radioscopically Guided Erector Spinae Plane Block for Postoperative Analgesia in Spine Surgery: A Randomized Clinical Trial

Beltrame

Fasano

Jalón

2022

J Neurol Surg A Cent Eur Neurosurg

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“…The most relevant findings from clinical trials and observational studies are described in the results. The erector spinae plane block: a review [26] Pneumothorax [38] Anesthesia [30][31][32] Plus S [31] Combined blockade [25][26][27] Bilevel [37] VATS [ [60] Anesthesia [61,62] ICU loss stay [64] Valve surgery [66,67] 3 T2/T3/T7 [88] Anesthesia [85,86] No USG [85] Spine surgery [ The erector spinae plane block: a review…”

Section: Methodsmentioning

confidence: 99%

The erector spinae plane block: a narrative review

Kot

Rodríguez

Granell

et al. 2019

Korean J Anesthesiol

208

146

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Regional anesthesia and pain management have experienced advances in recent years, especially with the advent of fascial plane blocks. The erector spinae plane block is one of the newest techniques to be described. In the past two years, publications referring to ESP block have increased significantly. The objective of this review is to analyze the articles about ESP block that have been published to date. We performed a search in the main databases and identified 368 articles. After a selection of the relevant articles, 125 studies were found eligible and were included in the review. The ESP block is performed by depositing the local anesthetic in the fascial plane, deeper than the erector spinae muscle at the tip of the transverse process of the vertebra. Many cases of its use have been described with satisfactory results in the treatment of both acute pain and chronic pain. The applicability of the technique covers many clinical scenarios. Of the 98 case reports reviewed, 12 and 87 articles, respectively described the technique as a treatment for chronic pain and acute pain. The single-shot was the most frequently used technique. As described in the articles published to date, the technique is easy to perform and has a low rate of complications. However, despite the effectiveness of the technique, further studies are necessary to obtain more evidence of its actions.

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“…There is a paucity of studies on ESP blocks performed on patients with SCS for postoperative analgesia after thoraco-abdominal surgeries. We found only one published report of successful ESP block utilization for a patient with a cervical SCS; however, the block was to provide analgesia from the acute pain caused by the tunneling pathway created in the subcutaneous layer to connect the newly placed SCS to its implantable pulse generator [21].…”

Section: Discussionmentioning

confidence: 99%

Erector Spinae Plane Catheter for Postoperative Thoracotomy Pain in a Patient With Indwelling Spinal Cord Stimulators: A Case Report

Cheng¹,

Abrahams²,

Pak³

2022

Cureus

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Analgesia after thoracotomy is challenging but important as inadequate pain control may result in early postoperative complications and a higher risk for post-thoracotomy pain syndrome. The authors report the successful utilization of an erector spinae plane (ESP) catheter for post-thoracotomy analgesia in a 40-yearold female with two dual-leaded spinal cord stimulators (SCS) in the cervical and thoracic levels. Although thoracic epidural analgesia is the current standard, epidural catheterization may present with obstructive, mechanical, or infectious concerns in patients with SCS. The ESP block may be a preferable approach to postoperative analgesia after thoraco-abdominal surgery over the thoracic epidural for patients with SCS.

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Erector Spinae Plane Block at the Lower Thoracic Level for Postoperative Pain Management After Spinal Cord Stimulation Implantation

Cited by 3 publications

References 9 publications

Bilateral Radioscopically Guided Erector Spinae Plane Block for Postoperative Analgesia in Spine Surgery: A Randomized Clinical Trial

Bilateral Radioscopically Guided Erector Spinae Plane Block for Postoperative Analgesia in Spine Surgery: A Randomized Clinical Trial

The erector spinae plane block: a narrative review

Erector Spinae Plane Catheter for Postoperative Thoracotomy Pain in a Patient With Indwelling Spinal Cord Stimulators: A Case Report

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