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

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      Author(s): 1 , 2 , , 3 , 4 , 5
      Editor(s): ,
      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Cureus
      Publisher: Cureus
      Keywords: regional anesthesia, pain, erector spinae block, espb, erector spinae plane block

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          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.

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          The erector spinae plane (ESP) block: A pooled review of 242 cases

          Ban C.H. Tsui, Ahtziri Fonseca, Farrukh Munshey … (2019)
          The erector spinae plane block (ESPB) was first described in 2016 as a regional block for thoracic neuropathic pain. Given its short history, there are a paucity of controlled clinical trials, yet an abundance of case reports. The primary aim of this review is to examine pooled clinical data from published literature to gain an understanding of ESPB characteristics.
          Article 0 comments Cited 102 times – based on 0 reviews     Review now
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            Ultrasound guidance reduces the risk of local anesthetic systemic toxicity following peripheral nerve blockade.

            Michael Barrington, Roman Kluger (2024)
            Local anesthetic systemic toxicity (LAST) is a potentially life-threatening complication of local anesthetic administration. In this article, the results of the Australian and New Zealand Registry of Regional Anaesthesia were analyzed to determine if ultrasound-guided peripheral nerve blockade (PNB) was associated with a reduced risk of LAST compared with techniques not utilizing ultrasound technology.
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              Duration of analgesic effectiveness after the posterior and lateral transversus abdominis plane block techniques for transverse lower abdominal incisions: a meta-analysis.

              Joseph Abdallah, William J Laffey, R Brull … (2013)
              Both posterior and lateral transversus abdominis plane (TAP) block techniques provide effective early (0-12 h) postoperative analgesia after transverse incision surgery. However, whether either technique produces prolonged analgesia lasting beyond 12 h remains controversial. This meta-analysis examines the duration of analgesia associated with posterior and lateral TAP blocks in the first 48 h after lower abdominal transverse incision surgery. We retrieved randomized controlled trials (RCTs) investigating the analgesic effects of TAP block compared with control in patients undergoing lower abdominal transverse incision surgery. Outcomes sought included interval postoperative i.v. morphine consumption and also rest and dynamic pain scores at 12, 24, 36, and 48 h postoperatively. Opioid-related side-effects and patient satisfaction at 24 and 48 h were also assessed. The 12-24 h interval morphine consumption was designated as a primary outcome. Twelve RCTs including 641 patients were analysed. Four trials examined the posterior technique and eight assessed the lateral technique. Compared with control, the posterior TAP block reduced postoperative morphine consumption during the 12-24 h and 24-48 h intervals by 9.1 mg (95% CI: -16.83, -1.45; P=0.02) and 5 mg (95% CI: -9.54, -0.52; P=0.03), respectively. It also reduced rest pain scores at 24, 36, and 48 h, and also dynamic pain scores at 12, 24, 36, and 48 h. Differences were not significant with the lateral TAP block. Based on the comparisons with control, the posterior TAP block appears to produce more prolonged analgesia than the lateral TAP block. Future RCTs comparing these two techniques are required to confirm our findings.
              Article 0 comments Cited 70 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 2 January 2019
                Publication date (Electronic, collection): January 2019
                Volume: 11
                Issue: 1
                Electronic Location Identifier: e3815
                Affiliations
                [1 ] Anaesthesiology, Maltepe University Faculty of Medicine, Istanbul, TUR
                [2 ] Aneasthesiology, Maltepe University Faculty of Medicine, Istanbul, TUR
                [3 ] Anesthesiology, Maltepe University Faculty of Medicine, Istanbul, TUR
                [4 ] Anesthesiology, Maltepe University Faculity of Medicine, Istanbul, TUR
                [5 ] Pediatric Surgery, Maltepe University Faculty of Medicine, Istanbul, TUR
                Author notes
                Article
                DOI: 10.7759/cureus.3815
                PMC ID: 6402723
                PubMed ID: 30868029
                SO-VID: bf025e53-a1f6-4fa2-8c79-b1a763c406e8
                Copyright © Copyright © 2019, Tulgar et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 17 December 2018
                Date accepted : 2 January 2019
                Categories
                Subject: Anesthesiology

                Keywords: regional anesthesia,pain,erector spinae block,espb,erector spinae plane block
                Data availability:
                Keywords: regional anesthesia, pain, erector spinae block, espb, erector spinae plane block

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