<p>Anesthetic Techniques: Focus on Lumbar Erector Spinae Plane Block</p>

Abstract

Defined in the last decade, erector spinae plane block (ESPB) is one of the more frequently used interfacial plans, and it has been the most discussed block among the recently defined techniques. Lumbar ESPB administered at lumbar levels is relatively novel and is a new horizon for regional anesthesia and pain practice. In this article, we aim to explain and introduce different approaches and explain the possible mechanism of action of lumbar ESPB. The objective of this review is to analyze the case reports, clinical and cadaveric studies about lumbar ESPB that have been published to date. We performed a search in "Pubmed" and "Google Scholar" database. After a selection of the relevant studies, 59 articles were found eligible and were included in this review. While we believe that lumbar ESPB is reliable and easy, we suggest that its efficacy and indications should be verified with anatomical and clinical studies, and its safety should be confirmed with pharmacokinetic studies. Moreover, the possibility of complications must be considered.

Efficacy of Erector Spinae Nerve Block for Pain Control After Spinal Surgeries: An Updated Systematic Review and Meta-Analysis

“…ESPB block is induced through injection of local anesthetic between the erector spinae muscle and the transverse process of the vertebrae (9)(10)(11). Upon injection, the anesthetic diffuses both cranially and caudally and acts on the dorsal rami of the spinal nerves.…”

“…Initially the use of ESPB was demonstrated for treating pain associated with shingles (9). It is a paravertebral interfascial block wherein the anesthetic is injected between the transverse process of the vertebrae and erector spinae muscle (10,11). Upon being injected, the anesthetic diffuses both cranially and caudally and exerts its action on the ventral and dorsal rami of the spinal nerves (9)(10)(11).…”

“…It is a paravertebral interfascial block wherein the anesthetic is injected between the transverse process of the vertebrae and erector spinae muscle (10,11). Upon being injected, the anesthetic diffuses both cranially and caudally and exerts its action on the ventral and dorsal rami of the spinal nerves (9)(10)(11). As the local anesthetic is injected in a plane that is farther from the spinal cord, the associated risk of causing trauma to the cord and consequent complication is minimized.…”

Fluoroscopic-guided erector spinae plane block for spine surgery

“…[ 7 ] Lumbar ESPB may lead to motor weakness, as local anesthetic can potentially spread anterior of the transverse process to the lumbar plexus and lumbar spinal nerves. [ 8 ] Interfascial blocks are volume dependent for spread, and the amount required differs on the region. Five milliliters at the vertebral level is indicated in the lumbar region versus 2.5 ml per thoracic level.…”

Internet of Things-Based Ultrasound-Guided Erector Spinae Plane Block Combined with Edaravone Anesthesia in Thoracoscopic Lobectomy

“…It was first applied to severe acute postoperative pain and neuropathic pain in 2016, and it was successful. Studies have shown that ESPB is easy to operate, has high safety, low error rate, good analgesic effect, and few adverse reactions, and shows broad clinical application prospects [ 10 ].…”