Ultrasound‐guided Erector Spinae Plane Block (US‐ESPB)—Anesthetic block: Case report

Abstract

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Anesthetic management in a patient with Arnold‐Chiari malformation type 1,5: A case report

“…Although a Erector spinae block combined with lumbar plexus block, paravertebral block, and sacral plexus blocks with the support of sedoanalgesia could be performed in this case to minimize the risk of hemodynamic fluctuations and dural puncture related to NA, however the risk of local anesthetic toxicity would be effectively increased considering the total volume and dose administration. 16 , 17 , 18 Epidural anesthesia was therefore our choice because it may offer several advantages over SA and GA in patients with ACM‐1,5. These advantages include avoidance the risk of difficult intubation and unsuccessful airway protection, reduced incidence of hypotension and deterioration of autonomic neuropathy, and minimal change in intracranial pressure if the anesthetic is titrated gradually.…”

Opioid-free anesthesia—dexmedetomidine as adjuvant in erector spinae plane block: a case series

“…The limit, however, is currently the unpredictability of the diffusion of the mixture despite a correct execution of the technique. Our recent clinical case showed the efficacy and safety of a multidermatomal spread with the use of LA at anesthetic concentrations [ 11 , 12 ]. Since one of the most common causes of block failure is the injection of the LA into an improper site, that is the rib, in our clinical case the choice of a cranial-caudal approach was well considered before performing the procedure.…”

Erector spinae plane block in laparoscopic nephrectomy as a cause of involuntary hemodynamic instability: A case report

“…This wide metameric distribution confirms the spread of the LA in the epidural space, as supported by Forero, Schwartzmann, Vidal, Chin et al 2‐5 To locate T8, we counted the lamina starting from the sacrum using the ultrasound method illustrated by Selvi in his study 14 . ESPB gave effective analgesia, and it is simple and safe to perform, 15 but there may be complications related to the spread of the LA, such as an unexpected motor block described by Selvi et al 16 Side effects can occur because the amount of LA that will spread in the epidural space is not completely controllable and predictable 17 . For this reason, in our opinion it would be appropriate to identify any variables favoring LA spread, in order to standardize the ESPB procedure as much as possible, such as patient's position or needle entry mode, as claimed by Tulgar et al, Milone et al and Tsui et al 9,12,18 In the case we reported, there were severe intraoperative hypotension and bradycardia, peaking at 15 minutes from the execution of ESPB and requiring inotropes.…”