Erector spinae plane block with catheter infusion for analgesia in a patient undergoing transaxillary first rib resection

Abstract

Analgesia for first rib resection can be challenging with short-and long-term consequences for patients such as acute distress, difficulty participating in physiotherapy and chronic pain. We report utilising an erector spinae plane block with a continuous infusion catheter as analgesia for a transaxillary first rib removal in a patient with venous thoracic outlet syndrome (Paget-Schroetter syndrome). We could find no reports of erector spinae plane block in transaxillary rib resection, and a limited number of reports using a paravertebral approach to analgesia for this procedure. In our case, an erector spinae plane block provided effective analgesia, allowing the patient to participate freely in postoperative physiotherapy; no complications of erector spinae plane block were encountered. Further research into the safety and efficacy of erector spinae plane block for first rib resection is warranted.

Erector Spinae versus Surgically Placed Pain Catheters for Thoracic Outlet Decompression

“…10,11 Few reports studies have studied erector spinae catheter use in multimodal pain management, especially in the setting of TOS decompression. A case study by McCance et al 12 found continuous ESP block to be an effective mode of analgesia in combination with NSAIDs and opioids but did not include direct comparison to paravertebral blocks such as the surgically placed catheters in the present study. Guffey et al 13 performed a comparative study of single-injection erector spinae injections and continuous perineural infusion catheters, finding that the injections were not inferior to the infusion catheters.…”

Effective Postoperative Pain Management in Thoracic Outlet Syndrome Surgery: The Role of the Erector Spinae Plane Block

“…One retrospective study discussed the use of the pectoral block II with the transaxillary technique, but its conclusions reported no decrease in pain scores or opioid usage [ 5 ]. Another case report highlighted the effective analgesic results of a continuous ESP block used in the transaxillary method [ 6 ].…”