Erector spinae plane block as an alternative to epidural analgesia for post-operative analgesia following video-assisted thoracoscopic surgery: A case study and a literature review on the spread of local anaesthetic in the erector spinae plane

• Published in: Indian journal of anaesthesia Vol. 62; no. 1; pp. 75 - 78
• Main Authors: Adhikary, Sanjib, Pruett, Ashlee, Forero, Mauricio, Thiruvenkatarajan, Venkatesan
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01.01.2018; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Analgesics; Anesthesia; Anesthesiology; Case Report; Catheters; Comparative analysis; Drug dosages; epidural analgesia; Epidural anesthesia; Erector spine block; Gastrointestinal surgery; local anaesthetic spread; Local anesthesia; Methods; Pain; Patients; Thoracic surgery; Thoracoscopy; Ultrasonic imaging; video-assisted thoracoscopic surgery; Erector spine block; epidural analgesia; local anaesthetic spread; video-assisted thoracoscopic surgery
• ISSN: 0019-5049; 0976-2817
• DOI: 10.4103/ija.IJA_693_17

Post-operative pain after minimally invasive video-assisted thoracoscopic surgery (VATS) in adults is commonly managed with oral and parenteral opioids and invasive regional techniques such as thoracic epidural blockade. Emerging research has shown that the novel erector spinae plane (ESP) block, can be employed as a simple and safe alternative analgesic technique for acute post-surgical, post-traumatic and chronic neuropathic thoracic pain in adults. We illustrate this by presenting a paediatric case of VATS, in which an ESP block provided better analgesia, due to greater dermatomal coverage, as well as reduced side-effects when compared with a thoracic epidural that had previously been employed on the same patient for a similar procedure on the opposite side.