Erector spinae plane block

Abstract

The interfascial plane blocks are ultrasound-guided regional blocks characterized with local anesthetic injection in the space between two muscles. Simple performance of these blocks, short technique learning curve, lack of side effects and analgesia for 24 hours make these blocks popular in everyday practice. Erector spinae plane block (ESPB) is a new ultrasound-guided interfascial technique where local anesthetic is injected deep to the erector spinae muscle and superficial to the transverse process of the vertebra. Its first use was described for chronic pain management. Later on ESPB found its place in acute pain treatment for pain relief in rib fractures and as a part of perioperative multimodal pain management following cardio-thoracic, abdominal, hip, and femur surgery. ESPB produces an extensive multi-dermatomal sensory block with no motor block. Studies had shown that ESPB reduces perioperative opioid use and pain score postoperatively. ESPB performance is safe in patients with coagulation disorders, and is associated with a much lower risk of nerve damage and pneumothorax compared with epidural analgesia and paravertebral blocks. The ESPB can be used for perioperative pain management in patients from premature infants to elderly patients with multiple comorbidities. The ESPB as simple and safe technique has application in acute postoperative and post-traumatic pain management, as well as chronic pain conditions.

Keywords

• interfascial block
• erector spinae plane block
• espb
• ultrasound-guided block