Low thoracic erector spinae plane block for perioperative analgesia in lumbosacral spine surgery: a case series

Abstract

The ESP block can contribute significantly to a perioperative multimodal opioid-sparing analgesic regimen and enhance recovery after lumbosacral spine surgery.

Ultrasound-guided erector spinae plane block for acute pain management in patients undergoing posterior lumbar interbody fusion under general anaesthesia

“…The choice was the T10 or T12 transverse process level in six cases of lumbosacral spine surgery for their bilateral ESP blocks, targeting sensory block between L2-S1. 1 Also, adequate and effective ESP blocks at the level of the L2 transverse process were done by Takahashi et al 10 Their target was to block an area extending from T12 to L5 but they used 20 ml of 0.1875% ropivacaine.…”

“…Failure to achieve adequate pain relief with conservative management therapy makes surgical intervention necessary and posterior lumbar interbody fusion (PLIF) is the management of choice. 1 Control of postoperative spine surgery pain remains a challenge for the anaesthesiologist. In addition to incisional pain, these patients experience pain arising from deeper tissues, such as bones, ligaments, muscles, intervertebral disks, facet joints and damaged nerve roots.…”

“…6 Recent reports stated that ESPB is effective during surgical interventions and strengthens perioperative analgesia when done at lower thoracic vertebrae. 1 To our knowledge, few publications are available which address the use of ESPB in spine surgeries. The aim of this study is to evaluate the efficacy of bilateral single shot ultrasound-guided ESPB for acute postoperative pain management in patients with double level lumbar spondylolisthesis (L3-L5) and candidates for posterior lumbar interbody fusion (PLIF) surgery under general anaesthesia.…”

Reply to Dr Cornish

“…7 As Dr Cornish observes, the location of the lipoma prevented us from injecting at the transverse processes congruent with its spinal nerve innervation. It did not, however, prevent us from scanning and visualizing fluid spread Does the Use of Regional Anesthesia for Below-Knee Amputation Reduce the Need for Perioperative Blood Transfusions?…”

“…5 Neither have the authors commented about the trigger hemoglobin level for blood transfusion and target hemoglobin level aimed to achieve postoperatively. 6,7 Considering the patients who have deranged coagulation may bleed more in the postoperative period, the authors should have compared this important hematological profile.…”