Erector Spinae Plane Block: Review Article

Azmy, Ahmed Mahmoud; Abdelrahman, Abdelrahman Hassan; Badwy, Fawzy Abbas; Mahmoud, Walaa H.; Taha, Al Haitham Mohamed

doi:10.21608/ejhm.2021.188558

Cited by 3 publications

(3 citation statements)

References 33 publications

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“…Regarding the reported side effects, Azmy et al stated that complications of ESB are infrequent because the site of the block is far away from the spinal cord, the pleura, and any major blood vessels [ 20 ]. Additionally, Aoyama et al did not report any serious complications with ESB [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of different volumes spread of erector spinae block in postmastectomy pain syndrome management: a prospective randomized comparative study

Abdelghaffar,

Amer

2023

BMC Anesthesiol

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Background Postmastectomy pain is chronic pain that occurs in females after breast surgeries. In this study, we estimated the vertebral levels reached by two different volumes (20 ml and 30 ml solutions) in the erector spinae block (ESB), as well as assess pain improvement and patient satisfaction in females with postmastectomy pain syndrome. Methods Fifty patients were assigned to two groups. The 20 ml group received ESB with 10 ml of bupivacaine 0.5%, 1 ml of 40 mg/ml of methylprednisolone, 2 ml of non-ionic contrast, and 7 ml of saline 0.9%. The 30 ml group received ESB with 15 ml of bupivacaine 0.5%, 1 ml of 40 mg/ml of methylprednisolone, 2 ml of non-ionic contrast, and 12 ml of saline 0.9%. Results The mean numbers of the blockade segments were 5.12 ± 0.726 and 6.36 ± 0.569 in the 20 ml and 30 ml groups, respectively (P < 0.001). The T1 to T6 blockade levels were achieved in six patients (24%) in the 20 ml group, versus 23 patients (92%) in the 30 ml group (P < 0.001). The numerical rating scale (NRS) improved in the 30 ml group during the follow-up period, compared to the 20 ml group. The T1 to T6 blockade levels showed better NRS (P < 0.001) and patient satisfaction (P = 0.011) than other blockade levels. Conclusions The injection of a 30 ml solution of 0.25% bupivacaine with methylprednisolone in erector spinae block (ESB) may result in better analgesia and higher patient satisfaction in individuals with postmastectomy pain syndrome (PMPS) compared to a 20 ml solution. Trial registration ClinicalTrials.gov (NCT05192278) on 14/1/2022.

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Section: Discussionmentioning

confidence: 99%

Comparison of different volumes spread of erector spinae block in postmastectomy pain syndrome management: a prospective randomized comparative study

Abdelghaffar,

Amer

2023

BMC Anesthesiol

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“…Because of this, erector spinae plane blocks are now known to be a safer option than more conventional ones like epidural or para-vertebral blocks. It has been shown in numerous case studies to be effective in providing significant relief from visceral as well as somatic pain [8].…”

Section: Introductionmentioning

confidence: 99%

Anaesthetic Management for Mastectomy in a Male With Unilateral Gynecomastia: The Utilization of Thoracic Segmental Spinal Anaesthesia and Erector Spinae Plane Block

Paul,

Borkar

2023

Cureus

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Males are frequently affected by gynecomastia, a benign proliferative glandular tissue condition of the breast. Gynecomastia is usually treated with surgery to remove breast tissue. Using erector spinae plane block and thoracic segmental spinal anaesthesia in place of typical general anaesthesia during breast procedures has become more common in recent years. This case report presents the management of a 24year-old male with long-standing left breast gynecomastia. Using a combination of erector spinae plane block and thoracic segmental spinal anaesthesia, the patient had the breast tissue excised. The regulation of the neuroendocrine stress response, lower need for analgesics after surgery, and decreased postoperative nausea and vomiting are among the many benefits of the anaesthetic methods. With better patient outcomes, fewer surgical complications, and efficient postoperative pain management, these methods offer a compelling substitute for general anaesthesia. The range of surgical scenarios in which these techniques can be applied could be expanded by additional research and clinical experience.Categories: Anesthesiology Keywords: ultrasound-guided erector spinae plane block (espb), ultrasound guided espb, espb, gynecomastia, breast analgesia, erector spinae plane block (espb), thoracic segmental spinal anesthesia This case presentation provides a compelling example of the potential benefits of these novel anaesthetic techniques in improving patient care and reducing the drawbacks of conventional anaesthetic methods. It documents the effective implementation of these techniques in a 24-year-old male patient with a longstanding left breast enlargement. Case PresentationA 24-year-old male came to the hospital complaining of a lump in the left side of his chest for nine years.

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“…It lies in the intermediate layer of intrinsic back muscles covered by the thoracolumbar fascia and arises from the erector spinae aponeurosis, which is a common aponeurosis connecting with the thoracolumbar fascia, having a proximal attachment on the sacrum and the spinous processes of the lumbar vertebrae. 7 Although many studies have been conducted on various drugs to test their efficacy in combination with local anesthetics (LA) in locoregional anesthesia, studies on the effect of adjuvant drugs in ESPB are scarce. Hence, we aimed to compare the adjuvant effect of dexmedetomidine, and magnesium sulfate when added to bupivacaine 0.25% for ESPB.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the effect of dexmedetomidine versus magnesium sulphate as an adjuvant to bupivacaine in ultrasound guided erector spinae block; a prospective randomized trial

Refaat,

Abdelmageed,

Alwedeny

et al. 2023

Anaesth. pain intensive care

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Background & Objectives: Since the introduction of erector spinae plane block (ESPB) in 2016 it has been used with success in various thoracic, abdominal, and spine surgeries. Spine surgeries result in significant postoperative pain. Postoperative opioids provide adequate pain control in most of the cases, but some patients continue to suffer from uncontrolled pain. Patients receiving multiple doses of opioids suffer from various side effects including postoperative nausea and vomiting, constipation, and delayed ambulation. We aimed to compare effect of dexmedetomidine and magnesium sulfate given as adjuvants with bupivacaine 0.25% for ESPB. Methodology: It was a prospective randomized single-blinded study including 52 patients divided into 2 groups; one receiving ESPB with a combination of bupivacaine 0.25% plus magnesium sulfate and the other receiving the same block with a combination of bupivacaine 0.25% plus dexmedetomidine. Results: The group receiving bupivacaine and dexmedetomidine had a prolonged postoperative analgesia duration as well as a decreased total opioid consumption (P < 0.05) compared to group receiving bupivacaine 0.25% plus magnesium sulfate, but had a significant decrease in intraoperative pulse rate and blood pressure compared to the group receiving bupivacaine 0.25% plus magnesium sulfate (P < 0.05). Conclusion: Although dexmedetomidine results in prolonged postoperative analgesia duration compared to magnesium sulfate when combined with bupivacaine 0.25% in ESPB, its negative effects on hemodynamics should be considered. Trial registration: This trial was registered on clinicaltrials.gov registry (NCT05694897) on 23/1/2023. Abbreviations: ASA: American Society of Anesthesiologist; ESPB: Erector Spinae Block; ERAS: Enhanced recovery After Surgery; SPSS: Statistical Package for Social Sciences; VAS: Visual Analog Score Key words: Erector Spinae Plane Block; Dexmedetomidine; Bupivacaine; Visual Analog Scale Citation: Refaat SA, Abdelmageed WM, Alwedeny HM, Soliman EH, Fouly MA. A randomized comparative trial of ultrasound guided erector spinae block with bupivacaine-magnesium sulphate vs. bupivacaine-dexmedetomidine for lumbar spine surgeries. Anaesth. pain intensive care 2023;27(5):425−430; DOI: 10.35975/apic.v27i5.2292 Received: July 15, 2023; Reviewed: August 16, 2023; Accepted: August 16, 2023

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Erector Spinae Plane Block: Review Article

Cited by 3 publications

References 33 publications

Comparison of different volumes spread of erector spinae block in postmastectomy pain syndrome management: a prospective randomized comparative study

Comparison of different volumes spread of erector spinae block in postmastectomy pain syndrome management: a prospective randomized comparative study

Anaesthetic Management for Mastectomy in a Male With Unilateral Gynecomastia: The Utilization of Thoracic Segmental Spinal Anaesthesia and Erector Spinae Plane Block

Evaluation of the effect of dexmedetomidine versus magnesium sulphate as an adjuvant to bupivacaine in ultrasound guided erector spinae block; a prospective randomized trial

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