scholarly journals Is lumbar erector spinae plane block (L-ESPB) a lumbar plexus block?: a case report of three cases

2022 ◽  
Vol 14 (1) ◽  
Author(s):  
Ashok Jadon ◽  
Rajendra Kumar Sahoo ◽  
Santosh Kumar Sharma
Keyword(s):  
Postoperative Pain ◽  
Mechanism Of Action ◽  
Local Anesthetic ◽  
Postoperative Pain Management ◽  
Erector Spinae ◽  
Lumbar Plexus ◽  
Anesthetic Technique ◽  
Erector Spinae Plane Block ◽  
Ionic Contrast ◽  
Plexus Block

Abstract Background Lumbar erector spinae plane block (L-ESPB) is being used in fractured hip patients for the postoperative pain relief and as a sole anesthetic technique. Various clinical and cadaveric studies have differences of opinion about its mechanism of action and pathways of local anesthetic spread; however, the role of lumbar plexus (LP) in the mechanism of action is still not considered. In our clinical experience, we observed that the action on LP could be a pathway for the analgesic action of local anesthetic along with paravertebral spread. Case presentation We report here three cases of the fractured hip who were given L-ESPB for postoperative pain management. The radiological examination was done after injection of non-ionic contrast to know the spread of local anesthetic. In two cases, the contrast spread was seen towards LP and in one case spread of contrast was observed towards the paravertebral area. Conclusions Effect of local anesthetic on the lumbar plexus is one of the plausible pathways in L-ESPB for its analgesic mechanism of action.

Epipleural surgical block and ultrasound-guided erector spinae plane block for analgesia in VATS

2021 ◽  
Keyword(s):  
Postoperative Pain ◽  
Thoracic Surgery ◽  
Postoperative Analgesia ◽  
Local Anesthetic ◽  
Erector Spinae ◽  
Ultrasound Guided ◽  
Additional Method ◽  
Video Tutorial ◽  
Erector Spinae Plane Block ◽  
Severe Postoperative Pain

Thoracic surgery is still associated with severe postoperative pain. In this video tutorial, we present 2 techniques that could be used as an additional method in a multimodal postoperative analgesia strategy for video-assisted thoracic surgery. We present the combination of an epipleural surgical infiltration of a local anesthetic with an ultrasound-guided erector spinae plane block.

scholarly journals Erector Spinae Block. A Narrative Review

2018 ◽  
Vol 1 (1) ◽  
pp. 28-39 ◽  
Author(s):  
María Bermúdez López ◽  
Álvaro Gasalla Cadórniga ◽  
José Manuel López González ◽  
Enrique Domínguez Suárez ◽  
Carlos López Carballo ◽  
...  
Keyword(s):  
Mechanism Of Action ◽  
Local Anesthetic ◽  
Medical Literature ◽  
Narrative Review ◽  
Erector Spinae ◽  
Ultrasound Guided ◽  
Thoracic Pain ◽  
Erector Spinae Plane Block

Abstract The erector spinae plane block is a novel ultrasound-guided technique that has recently been described for the management of acute and chronic thoracic pain. Currently an increasingly number of indications for the ESP block have been published. Nevertheless, the anatomy, mechanism of action, doses and volume of local anesthetic needed are still unclear. The aim of this narrative review is study this new block with base on the updated medical literature.

scholarly journals SHOULD THE ERECTOR SPINAE PLANE BLOCK BE APPLIED IN THE PAIN MANAGEMENT OF PERCUTANEOUS NEPHROLITHOTOMY?

2021 ◽  
Author(s):  
Şeyma Ünal ◽  
Semih Başkan ◽  
Betül GÜVEN AYTAÇ ◽  
İsmail Aytaç
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Percutaneous Nephrolithotomy ◽  
Length Of Hospital Stay ◽  
Postoperative Pain Management ◽  
Erector Spinae ◽  
Controlled Study ◽  
Control Group ◽  
Rescue Analgesia ◽  
Erector Spinae Plane Block

The Aim: This prospective, randomised controlled study aimed to investigate the efficacy and respiratory effects of postoperative pain management with erector spinae plane block (ESPB) in patients undergoing percutaneous nephrolithotomy surgery. Methods: A total of 60 ASA I-II patients aged 18–65 years, scheduled to undergo percutaneous nephrolithotomy (PCNL) were included. Patients were randomized either to the ESPB or control group. Ultrasound-guided ESPB with 15mL 0.5% bupivacaine at the T11 level was performed preoperatively using the in-plane technique in the ESP group. In both groups, 1gr of intravenous paracetamol was administered intraoperatively. Postoperative pain and agitation was evaluated using VAS, Dynamic VAS at 0, 6 and 24 hours and the Riker sedation-agitation scale at 0th Hours after surgery. Peak expiratory flow rate(PEFR) and SPO2 were measured in preoperative examination and at the 0th, 6th, 24th hours postoperatively. In the postoperative period, intravenous tramadol (100mg) was administered as a rescue analgesic when VAS ≥ 4. Time and number of the rescue analgesias, mobilization time and length of hospital stay were also recorded and analyzed. Results: A significantly lower VAS and DVAS were observed at 0th, 6th, 24th hours in the ESPB group (p < 0.05 for each timepoint). Also number of and time to rescue analgesia decreased in the ESPB group (p< 0.05 and 0.01 respectively). Postoperative/preoperative PEFR ratio was lower and there were more agitated patients in control group (p<0.05). Conclusion: ESPB may have additional clinical advantages while providing effective analgesia in patients who underwent PCNL comparing to intravenous analgesia.

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