Role of erector spinae plane block in end-of-life care for a patient with advanced abdominal malignancy

Abstract

Celiac plexus block (CPB) is the most commonly used intervention in patients suffering from pain related to upper abdominal malignancies. Placing a CPB requires a patient to be placed in a prone position on the operating room table which becomes difficult in many patients with advanced disease and therefore makes it more challenging for the interventional pain physician, simultaneously risky for the patient. In such cases, a more superficial minimally invasive intervention is desirable. The erector spinae plane block (ESPB) is one such intervention that has been used in a large variety of settings and can be used in the abovementioned cases. So far, no reports have emphasized the role of this field block for chronic cancer pain relief in a patient with advanced and progressive malignancy nearing the end of life. We present such a case with end-stage carcinoma gallbladder, in which ESPB was used effectively for providing pain relief during her final days.

Keywords

• end-of-life care
• erector spinae plane block
• malignancy
• pain relief