СVII level сervical ESP-block at the surgical treatment of a neck tumor: clinical case

Abstract

BACKGROUND: Еrector spinae plane (ESP) block at the level of СVII under ultrasound navigation control can be technically feasible and successfully used in surgical interventions in the topographic area above the level of the seventh cervical vertebra, which is the upper anatomic boundary for the m. erector spinae. At the same time, the available information on the clinical use of posterior cervical plane blockades, which also includes the ESP block, during surgical interventions in the cervical dorsal region is rather scarce.
 CLINICAL CASE DESCRIPTION: We present a clinical case of removal of a large benign tumor localized on the posterior surface of the neck in a patient who had a serious concomitant endocrine and cardiovascular pathology, using bilateral ESP-blockade, which was performed at the level of СVII under the control of ultrasound navigation in combination with local infiltration anesthesia directly in the area of the skin incision. The peculiarities of this case include the absence of ESP-block potentiation with general anesthetics, preservation of the patient’s consciousness during the surgical intervention, stable hemodynamics and good indices of gas metabolism in combination with the absence of any pain sensations, as well as satisfactory condition of the patient and his early activation in the postoperative period.
 CONCLUSION: The presented clinical case demonstrates the possibility of using ESP-block at the level of CVII in volumetric surgical intervention on the dorsal surface of the neck as the method of choice.