<p>Efficacy of bilateral erector spinae plane block in the management of pain: current insights</p>

Abstract

Erector spinae plane block (ESPB) is a newly described interfascial plane block, and the number of articles on the bilateral application of ESPB is increasing in the literature. In this paper, in addition to analyzing bilateral ESPB cases and studies published so far, we aimed to review the relevant anatomy, describe the mechanism of spread of the injectant, demonstrate varying approaches to ESPB, and summarize case reports and clinical trials, as well as provide current insight on this emerging and popular block. Randomized controlled studies, comparative studies of ESPB versus other methods, and pharmacokinetic studies of bilateral applications must be the next step in clearly understanding bilateral ESPB.

Erector Spinae Plane Block for Open and Laparoscopic Liver Surgery: Two Case Reports

“…Our experience corroborates with previous reports which showed that bilateral ESP blocks reduce opioid consumption when used as part of a multimodal analgesia approach [8]. Similar to previous reports, ESP blocks also appear to be more efficacious for somatic analgesia and less so for visceral analgesia [9] [10].…”

“…Since the first description of bilateral ESP block for post-operative analgesia in laparoscopic ventral hernia surgery [7], bilateral ESP blocks have been described in a myriad of other surgeries including thoracic, breast, abdominal and spine surgeries [8]. Being a relatively new technique, most of these were case reports and case series with a limited number of randomized trials and retrospective studies [8]. Most described its efficacy in pain control and reducing overall opioid requirements.…”

“…Initial clinical findings suggested that the injectate would spread to both the ventral and dorsal ramus of the spinal nerves to produce blockade of both somatic and visceral pain, allowing bilateral ESP blocks to mimic the effects of epidural analgesia [5] [6]. As the block can be performed at any spinal level unilaterally or bilaterally, there have been reports of its use in a wide range of surgical procedures including thoracic, spine, breast, upper and lower abdominal surgeries [7] [8].…”

Case Report: Treatment of Refractory Post‐Surgical Neuralgia With Erector Spinae Plane Block

“…Most studies report a craniocaudal spread of 3 to 7 levels; however, due to the regional anatomy, these numbers can change depending on the level. Further cadaveric and imaging studies are needed for more precise assessment . Since becoming a defined procedure, the ESP block has been reported to provide analgesia to the cervical and lumbar spine surgeries among others.…”

“…All PNBs of the scalp are field blocks with limited duration of action, usually 6 to 9 hours. ESP block was chosen over other options because it potentially lasts for more than 24 hours . Procedural consent was obtained by the pain service prior to the intervention.…”