Ultrasound-guided Erector Spinae Plane Block: Indications, Complications, and Effects on Acute and Chronic Pain Based on a Single-center Experience

Abstract

Introduction: Erector spinae plane block (ESPB) is a novel regional anesthesia technique used in postoperative pain and chronic neuropathic pain of the thoracoabdominal region. There are no previously published large case series. This retrospective review aimed to report the indications, levels of block, success of block and complications, and also to evaluate the effect of ESPB on postoperative/chronic pain. Methods: We retrospectively evaluated the charts and medical records of 182 patients who had ESPB in the last one year. All records were collected in the postoperative recovery room, ward, and pain unit. Results: ESPB performed at several different levels and for several different indications led to effective postoperative analgesia when part of a multimodal analgesia plan. Few complications were noted. Conclusion: ESPB is an interfascial plane block with many indications. The possibility of complications must be considered.

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

“…Similar to previous reports, ESP blocks also appear to be more efficacious for somatic analgesia and less so for visceral analgesia [9] [10]. Although there have been reports of block failure and lack of efficacy [11] [12], there is currently insufficient research into factors that may affect this such as the optimal volume, concentration and rate of local anaesthetic administration, level of catheter placement and factors related to patient or case selection. When performed at the T7 level, Chin et al [5] [7] suggested that local anaesthetic spread occurs from the upper thoracic to L2 -3 levels.…”

Efficacy of Ultrasound-Guided Bilateral Erector Spinae Plane Block for Pediatric Laparoscopic Cholecystectomy: Case Series

“…Motor weakness may occur when the block applied lower thoracic and lumbar level, which local anesthesia is allowed to spread to the lumbar plexus. [15] Author did not encounter any complications related to block in any of the cases.…”

“…[18] Tulgar et al applied 2.5 mg/kg for bupivacaine plus 4 mg/kg for lidocaine during ESPB block permormed and run across LAST related sentral nervous system toxicity such as aphasia/apthia, short-lasting loss of conciousness and tinnitus/vertigo. [15] The author performed a total of 2.5 mg/kg of 0.25% bupivacain to the bilateral ESPB block. The complications related to the cardiovascular system such as hypotension, dysrhythmia and cardiac arrest during the peroperative period, and central nervous system complications such as disorientation, tinnitus and seizures during postoperative period were not encountered.…”

“…The ESPB block can only act in the paraspinal area, but may also block the lateral side of the thoracoabdominal areas and the mid-abdomen. Therefore, block failure/lack of efficiency was defined the first time by Tulgar et al [15] Author did not evaluate dermatom areas in the postoperative period. However, author indicated that the block was effective, due to the postoperative NRS scores <3 and the absence of any analgesics requirement.…”

Should erector spinae plane block applications be standardized or should we revise nomenclature?

“…ESPB was initially described as being performed from cephalad to caudal using the in-plane technique. Thereafter, out-of-plane approaches were reported with a vast majority of clinicians preferring this approach 4. While some authors aim for interfascial plane deep to the erector spinae muscle in the in-plane technique, many applicants of both the in-plane and out-of-plane technique aim for the transverse process (TP).…”