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BackgroundSacral nerve stimulation is a therapeutic option with demonstrated efficacy for conditions presenting with perineal pain caused by different etiologies. We aimed to assess whether a sacral electrode (InterStim®, Medtronic, Minneapolis, MN, USA) inserted through the caudal pathway is able to offer an acceptable level of sacral stimulation and rate of catheter migration.MethodsWe present 12 patients with pelvic pain who received sacral neuromodulation via the sacral hiatus with the InterStim electrode. We evaluated patient satisfaction as well as migration and removal of the electrode, if necessary.ResultsOur experience included 12 patients, 10 women and two men, with a mean age of 60 years. In eight of the 12 patients, the initial therapy was effective, and the final system implantation was performed. During subsequent follow-up, patient satisfaction was good. To date, there have been no cases of electrode displacement or migration.ConclusionsThe caudal insertion of the InterStim electrode, with its own fixation system, and initially designed for transsacral insertion, appears in our experience to be a satisfactory option which can minimize electrode displacements, achieving similar results in therapeutic efficacy and causing no difficulties in removal.

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Erector spinae plane block is an interfacial block recently described that could have lots of applications in chronic or in postoperative acute pain. We present a case of a 34 year old woman that had an open splenectomy made after the surgery she suffered from postoperative pain, as high as 9 points in the visual analogue scale though intravenous analgesics. An ultrasound guided ESP block was performed. After the block the visual analogue scale was four points. ESP block could be a good option for treating postoperative pain for subcostal laparotomies