USG-guided continuous erector spinae block as a primary mode of perioperative analgesia in open posterolateral thoracotomy: A report of two cases

• Published in: Saudi journal of anaesthesia Vol. 12; no. 3; pp. 471 - 474
• Main Authors: Nath, Sayan, Bhoi, Debesh, Mohan, Virender, Talawar, Praveen
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.07.2018; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Abdomen; Aircraft; Analgesics; Anesthesia; Anesthesiology; Case Report; Catheters; Continuous; erector spinae block; thoracotomy; Critical care; Gastrointestinal surgery; Medicine; Narcotics; Ostomy; Pain; Pain management; Patients; Ultrasonic imaging; Ventilators; Vertebrae; Continuous; erector spinae block; thoracotomy
• ISSN: 1658-354X; 0975-3125
• DOI: 10.4103/sja.SJA_755_17

The postoperative pain management in open thoracotomy is very crucial as the effective analgesia can prevent respiratory and thrombotic complications and lead to early mobilization and discharge. The thoracic epidural analgesia is the gold standard in such surgeries; however, there are few adverse effects such as hypotension, dural puncture, and contralateral block that always warrants safer alternative. Recently, with the advent of ultrasound, the regional anesthetic techniques are getting more popular to avoid such complications. Erector spinae plane (ESP) block is one of the novel techniques that has been described as a safe thoracic paravertebral block. We are reporting here the continuous ESP block as a primary mode of postoperative analgesia which was continued for 48 h. The intraoperative opioid requirement was very less, and the maximum NRS score in postoperative period was 4 at 12 h, which was well managed with multimodal analgesic regimen along with rescue doses of opioid.