Ultrasound‐Guided Erector Spinae Plane Block and Trapezius Muscle Injection for Myofascial Pain Syndrome

Abstract

Objective There were two goals to this study: the first goal was to research the analgesic effectiveness of erector spinae plane block (ESPB) added to the treatment after trapezius muscle injection (TMI) and the second was to investigate whether repeated TMI increases the analgesic effect in myofascial pain syndrome (MPS). Methods Sixty patients with a diagnosis of MPS were randomized into two groups. The TMI group (n = 30) received ultrasound‐guided (USG) TMI with 5 mL of 0.25% bupivacaine two times, with a 1‐week interval in between. The ESPB group (n = 30) received USG TMI with 5 mL of 0.25% bupivacaine in the first week and USG ESPB with 20 mL of 0.125% bupivacaine in the second week. The pain severity of the patients was evaluated using the visual analog scale (VAS). The data obtained before (week 0) and after (weeks 1, 2, 3, and 4) the injections were statistically compared between the groups. Results In both groups, the mean VAS score decreased in the first week compared to the mean pretreatment score (p < .001). When the VAS scores were compared between the first and second weeks, a decrease was observed in both groups (p < .001), but it was more evident in the ESPB group. Compared to previous weeks, there was no significant difference in VAS scores at the third and fourth weeks. Conclusions The analgesic effect of repeated TMI for MPS was superior to a single injection, but ESPB combined with TMI provided more effective analgesia than repeated TMI.

Emergency-physician Performed, Ultrasound-guided Lateral Femoral Cutaneous Nerve Block for Meralgia Paresthetica: A Report of Two Cases

“…Ultrasound-guided nerve blocks have been shown to be efficacious for the treatment of musculoskeletal pain and neuropathic pain. 12 , 13 With the progressive integration of ultrasound in emergency medicine practice, ultrasound-guided nerve blockade for procedural analgesia, fracture analgesia, and atraumatic conditions such as sciatica, has become more commonplace. 14 , 15 The LFCN is a superficial, purely sensory nerve that is amenable to visualization on ultrasound.…”

Erector Spinae Plane Block and Chronic Pain: An Updated Review and Possible Future Directions

“…The use of ESP blocks in chronic myofascial pain (cervical and interscapular) was first reported in 2019, and randomized studies have shown that the ESP block is an effective pain relief method both when added to traditional treatment and when used alone [ 60 , 61 ]. However, as the source of pain in myofascial pain syndromes is controversial, the mechanism of this pain relief of ESP blocks and similar fascial plane blocks has not been fully clarified.…”

Incidentally Identified Posterior Intercostal Artery on the Interfascial Plane Between Transverse Process

“…Since being first defined, erector spinae plane block (ESPB) has been described as being “safer” by various authors, owing to its distance from neural and vascular tissues and its relatively low reported complication rates 1,2 . Although a PubMed search reveals over 900 papers on ESPB as of March 2022, these papers report very few complications.…”

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ince being first defined, erector spinae plane block (ESPB) has been described as being "safer" by various authors, owing to its distance from neural and vascular tissues and its relatively low reported complication rates. 1,2 Although a PubMed search reveals over 900 papers on ESPB as of March 2022, these papers report very few complications. All complications of ESPB such as motor block, the spread of local anesthetic (LA) to the opposite side, priapism, and Harlequin syndrome are related to the spread of LA to the paravertebral space and the sympathetic chain.

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