Local anesthetics and erector spinae plane blocks: a spotlight on pharmacokinetic considerations and toxicity risks

Cassai, Alessandro De; Geraldini, Federico; Costa, Fabio; Tulgar, Serkan

doi:10.1080/17425255.2022.2122811

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…It is difficult to distinguish between the two causes, and while plain lidocaine is known to provide up to 1 hour of anaesthesia, 32 it has been reported in humans that both lidocaine and bupivacaine have a rapid rate of absorption from the erector spinae plane. 33 The use of large volumes of local anaesthetic to achieve the desired effect in facial plane blocks raises concerns regarding toxicity risks. Indeed, one of the proposed mechanisms of action of these blocks is vascular absorption of local anaesthetic and systemic effects at distant sites.…”

Section: Discussionmentioning

confidence: 99%

“…Mild reactivity (moving side to side) at the very end of the procedure could be either a result of increased nociception or discomfort, secondary to standing for a long period of time. It is difficult to distinguish between the two causes, and while plain lidocaine is known to provide up to 1 hour of anaesthesia, 32 it has been reported in humans that both lidocaine and bupivacaine have a rapid rate of absorption from the erector spinae plane 33 . The use of large volumes of local anaesthetic to achieve the desired effect in facial plane blocks raises concerns regarding toxicity risks.…”

Section: Discussionmentioning

confidence: 99%

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Clinical application of a described erector spinae plane block for locoregional anaesthesia technique in a cow undergoing standing laparotomy

d'Anselme,

Gamsjäger,

Ringer

et al. 2023

Vet Record Case Reports

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A 5‐year‐old post‐parturient Holstein Friesian cow, with a history of decreased milk production, decreased appetite and metritis, was referred for left abomasal displacement, which was corrected by right paralumbar omentopexy. After aseptic preparation of the right flank, an erector spinae plane block was performed under ultrasound guidance, using 20 mL of lidocaine 2% per point of injection, at the level of the thoracic vertebra 13, and the lumbar vertebrae 1 and 2 to provide flank anaesthesia. The cow reacted to the last 2 cm of the oblique skin incision, that corresponded to the most caudal portion of the flank. After local infiltration of the distal incision with 20 mL lidocaine 2%, the procedure was uneventful, with no anaesthesia‐related complications and no reactions to surgical stimulation. The present report describes the clinical application of the erector spinae plane block to provide flank anaesthesia in a cow undergoing standing laparotomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical application of a described erector spinae plane block for locoregional anaesthesia technique in a cow undergoing standing laparotomy

d'Anselme,

Gamsjäger,

Ringer

et al. 2023

Vet Record Case Reports

View full text Add to dashboard Cite

show abstract

“…Signs of systemic toxicity include central nervous system depression, seizures, cardiovascular collapse, and respiratory arrest [ 53 ]. To prevent systemic toxicity, practitioners should use ultrasound guidance to confirm the needle tip location and avoid injecting large volumes of local anesthetic [ 54 ]. LAST following an ESP block has been well reported and described in a case series by Tulgar et al [ 49 ].…”

Section: Esp Block Rate Of Complicationsmentioning

confidence: 99%

Erector Spinae Plane Block and Chronic Pain: An Updated Review and Possible Future Directions

De Cassai,

Geraldini,

Freo

et al. 2023

Biology

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Chronic pain is a common, pervasive, and often disabling medical condition that affects millions of people worldwide. According to the Global Burden of Disease survey, painful chronic conditions are causing the largest numbers of years lived with disability worldwide. In America, more than one in five adults experiences chronic pain. Erector spinae plane block is a novel regional anesthesia technique used to provide analgesia with multiple possible uses and a relatively low learning curve and complication rate. Here, we review the erector spinae plane block rationale, mechanism of action and possible complications, and discuss its potential use for chronic pain with possible future directions for research

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Systemic lidocaine versus erector spinae plane block for improving quality of recovery after laparoscopic cholecystectomy: A randomized controlled trial

Lin,

Chen,

Xie

et al. 2024

Journal of Clinical Anesthesia

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Local anesthetics and erector spinae plane blocks: a spotlight on pharmacokinetic considerations and toxicity risks

Cited by 5 publications

References 13 publications

Clinical application of a described erector spinae plane block for locoregional anaesthesia technique in a cow undergoing standing laparotomy

Clinical application of a described erector spinae plane block for locoregional anaesthesia technique in a cow undergoing standing laparotomy

Erector Spinae Plane Block and Chronic Pain: An Updated Review and Possible Future Directions

Systemic lidocaine versus erector spinae plane block for improving quality of recovery after laparoscopic cholecystectomy: A randomized controlled trial

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