The erector spinae plane block (ESPB) in the management of chronic thoracic pain. Correlation of pain/analgesia areas and long term effect of the treatment in three cases

Baixauli, P. Kot; Gimillo, P. Rodriguez; Gosalvez, J. Baldo; Ibáñez, J. De Andrés

doi:10.1016/j.redar.2019.02.010

Cited by 4 publications

(2 citation statements)

References 9 publications

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“…The efficacy of ESP block in chronic pain is not well established, contrary to the TAP block, which decreased the risk of persistent postsurgical pain after laparoscopic cholecystectomy according to Piraccini et al 38 However, some trials highlighted the potential use of ESP block in the management of chronic pain following surgeries, which was not assessed in the retained studies. 39,40 Finally, for a better appraisal of the utility of the ESP block in painless procedures, further prospective trials remain mandatory.…”

Section: Discussionmentioning

confidence: 99%

Bilateral Erector Spinae Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy: A Systematic Review and Meta‐analysis of Randomized Controlled Trials

et al. 2020

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Background: Erector spinae plane (ESP) block is a novel regional anesthetic technique. Its application for postoperative analgesia has been increasing since 2016; however, its effectiveness remains uncertain and varies according to the type of surgery. This meta-analysis aimed to assess the analgesic efficacy of ESP block in patients undergoing laparoscopic cholecystectomy. Methods: Literature searches of electronic databases and manual searches up to June 1, 2020 were performed. Review Manager Version 5.3 was used for pooled estimates. We included only randomized controlled trials (RCTs) in this meta-analysis. The random-effects meta-analysis model was used, and metaregression was applied when appropriate. Results: A total of five RCTs consisting of 250 patients were included (124 in the ESP block group vs. 126 in the control group). Bilateral ESP block showed a significant reduction in postoperative intravenous opioid consumption reported up to 24 hours after surgery (mean difference [MD] = À4.46, 95% confidence interval [CI] [À5.50 to À3.42], P < 0.001) and in the time to first rescue analgesic (MD = 73.27 minutes, 95% CI [50.39 to 96.15], P < 0.001). According to the results of four studies, the postoperative pain score was lower in the ESP group compared with the control group at both rest and movement. There were no differences between the two groups as concerns nausea (odds ratio [OR] = 0.45, 95% CI [0.13 to 1.52], P = 0.20) and vomiting (OR = 0.37, 95% CI [0.10 to 1.35], P = 0.13). No block-related complications were noted. Conclusion: This meta-analysis showed that bilateral ultrasound-guided ESP block could be considered as an effective option to reduce opioid consumption and the time to first rescue analgesic and seems to be also a safe technique in adults undergoing laparoscopic cholecystectomy. &

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Section: Discussionmentioning

confidence: 99%

Bilateral Erector Spinae Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy: A Systematic Review and Meta‐analysis of Randomized Controlled Trials

et al. 2020

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“…3,5 In the literature, dermatomal coverage of sensory block caused by ESPB has been reported only rarely. 2,6,7 Cadaveric and imaging studies performed to determine the anatomic spread of local anesthetic (LA) in ESPB have demonstrated differing results leading to continued uncertainty regarding the mechanism of this block. [8][9][10][11][12] While quadrant evaluation has been reported in correspondences, there are no case series or clinical studies evaluating the dermatomal and quadrant sensory block of ESPB.…”

Section: Introductionmentioning

confidence: 99%

Quadrant and Dermatomal Analysis of Sensorial Block in Ultrasound- Guided Erector Spinae Plane Block

Selvi¹,

Tulgar²,

Şerifsoy³

et al. 2022

Eurasian J Med

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Objective: As a novel procedure now gaining popularity, erector spinae plane block has been the subject of many studies. However, dermatomal coverage of the sensory block caused by erector spinae plane block has been rarely studied. The goal of this study is to evaluate the sensory block resulting from erector spinae plane block applied at the T9 vertebral level.Materials and Methods: This observational, prospective, blinded study was conducted on 50 adult patients undergoing laparoscopic abdominal surgery. All patients underwent bilateral erector spinae plane block at the T9 level after completion of the surgery while under general anesthesia. In order to further evaluate the sensory blockade, we divided the hemiabdomen-hemithorax region into 4 quadrants: dorsal-medial, dorsallaterel, ventral-lateral, and ventral-medial. The sensorial evaluation was performed using the pinprick test, 2 hours following the application of erector spinae plane block.Results: A total of 28 female and 22 male patients were examined in this study. Complete failure of the block was recorded in 7 patients, with no thoracic/lumbar segmental or quadrant involvement. Successful sensory block was achieved in 67% of the dorsolateral quadrants, 58% of the dorsomedial quadrants, 69% of the ventrolateral quadrants, and 55% of the ventromedial quadrants. Conclusion:Cutaneous sensory block of erector spinae plane block at T9 vertebral level revealed variable results and low failure rates. Administration of erector spinae plane block for postoperative analgesia in thoracoabdominal surgeries requires further randomized controlled trials to confirm its effectiveness and convenience.

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Erector spinae plane block and anterior sympathetic chain spread: a matter still under discussion

Galacho

Veiga

2020

Reg Anesth Pain Med

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The erector spinae plane block (ESPB) in the management of chronic thoracic pain. Correlation of pain/analgesia areas and long term effect of the treatment in three cases

Cited by 4 publications

References 9 publications

Bilateral Erector Spinae Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy: A Systematic Review and Meta‐analysis of Randomized Controlled Trials

Bilateral Erector Spinae Plane Block for Postoperative Analgesia in Laparoscopic Cholecystectomy: A Systematic Review and Meta‐analysis of Randomized Controlled Trials

Quadrant and Dermatomal Analysis of Sensorial Block in Ultrasound- Guided Erector Spinae Plane Block

Erector spinae plane block and anterior sympathetic chain spread: a matter still under discussion

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