The Ultrasound-Guided Continuous Erector Spinae Plane Block for Postoperative Analgesia in Video-Assisted Thoracoscopic Lobectomy

Scimia, Paolo; Ricci, E; Droghetti, Andrea; Fusco, Pierfrancesco

doi:10.1097/aap.0000000000000616

Cited by 85 publications

(48 citation statements)

References 4 publications

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“…This is a cadaveric study, and changes in tissue integrity could have affected diffusion of the injectate. Both retrolaminar and ESP blocks are usually performed in the sitting or lateral position ; the dimensions of the SCTL and intercostal space in the sitting or lateral position with the thoracic spine flexed might be somewhat different from the prone position . Also, in living subjects, the dimensional change in the SCTL during inspiration and expiration can lead to delayed injectate diffusion to the paravertebral space.…”

Section: Discussionmentioning

confidence: 99%

“…Although this procedure is frequently used, there remains a potential risk of pneumothorax or unintentional neuraxial injection when performed either with or without ultrasound guidance . Recently, more superficial needle placement techniques such as retrolaminar block , erector spinae plane (ESP) block , midpoint transverse process to pleura (MTP) block and intercostal/paraspinal block have been utilised as alternatives to conventional thoracic paravertebral blocks. These more superficial blocks do not approach the pleura, and thus avoid one of the major risks of conventional paravertebral block.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of injectate spread and nerve involvement between retrolaminar and erector spinae plane blocks in the thoracic region: a cadaveric study

et al. 2018

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Although different injection locations for retrolaminar and erector spinae plane blocks have been described, the two procedures have a similar anatomical basis. In this cadaveric study we compared anatomical spread of dye in the thoracic region following these two procedures. Following randomisation, 10 retrolaminar blocks and 10 erector spinae plane blocks were performed on the left or right sides of 10 unembalmed cadavers. For each block, 20 ml of dye solution was injected at the T5 level. The back regions were dissected and the involvement of the thoracic spinal nerve was also investigated. Twenty blocks were successfully completed. A consistent vertical spread, with deep staining between the posterior surface of the vertebral laminae and the overlaying transversospinalis muscle was observed in all retrolaminar blocks. Moreover, most retrolaminar blocks were predominantly associated with fascial spreading in the intrinsic back muscles. With an erector spinae plane block, dye spread in a more lateral pattern than with retrolaminar block, and fascial spreading in the back muscles was also observed. The number of stained thoracic spinal nerves was greater with erector spinae plane blocks than with retrolaminar blocks; median 2.0 and 3.5, respectively. Regardless of technique, the main route of dye spread was through the superior costotransverse ligament to the ipsilateral paravertebral space. Although erector spinae plane blocks were associated with a slightly larger number of stained thoracic spinal nerves than retrolaminar blocks, both techniques were consistently associated with posterior spread of dye and with limited spread to the paravertebral space.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of injectate spread and nerve involvement between retrolaminar and erector spinae plane blocks in the thoracic region: a cadaveric study

et al. 2018

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“…Studies have shown that the spread of LA in the paravertebral space in the cephalic and caudal direction can lead to analgesia from C7-T2 to L2-3 [4]. For that reason the block was successfully used in acute pain management in pneumothorax surgery (ESP block at T6 level) [26], applied in video-assisted thoracoscopic surgery (VATS) [27], minimally invasive mitral valve surgery via thoracotomy incisions (ESP block at the level of the T7 transverse process) [8], postoperative analgesia after caesarean section (at T9 level) [28], postoperative analgesia in retropubic radical prostatectomy (over the 12th thoracic vertebrae) [29], different laparoscopics abdominal surgeries [19], laparoscopic cholecystectomy in the ambulatory setting [30] and bariatric surgery [17], as examples.…”

Section: Thoracic and Abdominal Chronic And Acute Pain Managementmentioning

confidence: 99%

Erector Spinae Block. A Narrative Review

López

Cadórniga

González

et al. 2018

Central European Journal of Clinical Research

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The erector spinae plane block is a novel ultrasound-guided technique that has recently been described for the management of acute and chronic thoracic pain. Currently an increasingly number of indications for the ESP block have been published. Nevertheless, the anatomy, mechanism of action, doses and volume of local anesthetic needed are still unclear. The aim of this narrative review is study this new block with base on the updated medical literature.

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“…The original description used multiple level injections for breast surgery. There have been subsequent case reports of its use in breast surgery and video‐assisted thoracoscopic surgery (VATS) . A recent report describes a single‐level MTP block for surgical anaesthesia during breast surgery and supports the suggestion of multiple nerve root coverage from a single injection .…”

Section: Introductionmentioning

confidence: 93%

Midpoint transverse process to pleura catheter placement for postoperative analgesia following video‐assisted thoracoscopic surgery

Watton

Rose

Abdallah

et al. 2019

Anaesthesia Reports

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The ultrasound-guided midpoint transverse process to pleura block has been described as an alternative endpoint for thoracic paravertebral blockade. Although originally described as a single-level block, midpoint transverse process to pleura blockade may cover more than one level when larger volumes of injectate are used. Moreover, a continuous catheter midpoint transverse process to pleura blockade technique was previously thought to be unfeasible. We report three cases where a midpoint transverse process to pleura continuous catheter technique was successfully used for postoperative analgesia following video-assisted thoracoscopic surgery.

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The Ultrasound-Guided Continuous Erector Spinae Plane Block for Postoperative Analgesia in Video-Assisted Thoracoscopic Lobectomy

Cited by 85 publications

References 4 publications

Comparison of injectate spread and nerve involvement between retrolaminar and erector spinae plane blocks in the thoracic region: a cadaveric study

Comparison of injectate spread and nerve involvement between retrolaminar and erector spinae plane blocks in the thoracic region: a cadaveric study

Erector Spinae Block. A Narrative Review

Midpoint transverse process to pleura catheter placement for postoperative analgesia following video‐assisted thoracoscopic surgery

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