Статья

The Erector Spinae Plane Block

Mauricio ForeroFrom the *Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada; Departments of †Anesthesiology and Perioperative Medicine, and ‡Orthopedic Surgery and Radiology, Penn State Hershey College of Medicine, Hershey, PA; §Michael G. DeGroote School of Medicine, McMaster University, Hamilton; and ∥Department of Anesthesia, University of Toronto, Toronto, Ontario, CanadaSanjib Das AdhikaryFrom the *Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada; Departments of †Anesthesiology and Perioperative Medicine, and ‡Orthopedic Surgery and Radiology, Penn State Hershey College of Medicine, Hershey, PA; §Michael G. DeGroote School of Medicine, McMaster University, Hamilton; and ∥Department of Anesthesia, University of Toronto, Toronto, Ontario, CanadaHector LopezFrom the *Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada; Departments of †Anesthesiology and Perioperative Medicine, and ‡Orthopedic Surgery and Radiology, Penn State Hershey College of Medicine, Hershey, PA; §Michael G. DeGroote School of Medicine, McMaster University, Hamilton; and ∥Department of Anesthesia, University of Toronto, Toronto, Ontario, CanadaCalvin TsuiFrom the *Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada; Departments of †Anesthesiology and Perioperative Medicine, and ‡Orthopedic Surgery and Radiology, Penn State Hershey College of Medicine, Hershey, PA; §Michael G. DeGroote School of Medicine, McMaster University, Hamilton; and ∥Department of Anesthesia, University of Toronto, Toronto, Ontario, CanadaKi Jinn Chin

2016en

ABI

Аннотация

Thoracic neuropathic pain is a debilitating condition that is often poorly responsive to oral and topical pharmacotherapy. The benefit of interventional nerve block procedures is unclear due to a paucity of evidence and the invasiveness of the described techniques. In this report, we describe a novel interfascial plane block, the erector spinae plane (ESP) block, and its successful application in 2 cases of severe neuropathic pain (the first resulting from metastatic disease of the ribs, and the second from malunion of multiple rib fractures). In both cases, the ESP block also produced an extensive multidermatomal sensory block. Anatomical and radiological investigation in fresh cadavers indicates that its likely site of action is at the dorsal and ventral rami of the thoracic spinal nerves. The ESP block holds promise as a simple and safe technique for thoracic analgesia in both chronic neuropathic pain as well as acute postsurgical or posttraumatic pain.

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Идентификаторы

DOI: 10.1097/aap.0000000000000451

Цитирования и источники

Цитирований: 3Использованных источников: 0

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