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Indian J Anaesth. 2018 Jan;62(1):75-78. doi: 10.4103/ija.IJA_693_17.

Erector spinae plane block as an alternative to epidural analgesia for post-operative analgesia following video-assisted thoracoscopic surgery: A case study and a literature review on the spread of local anaesthetic in the erector spinae plane.

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Department of Anaesthesiology and Perioperative Medicine, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA.
Department of Anesthesia, McMaster University, Hamilton, Ontario.
Discipline of Acute Care Medicine, The University of Adelaide, Adelaide, South Australia.
Department of Anaesthesia, The Queen Elizabeth Hospital, Adelaide, South Australia.


Post-operative pain after minimally invasive video-assisted thoracoscopic surgery (VATS) in adults is commonly managed with oral and parenteral opioids and invasive regional techniques such as thoracic epidural blockade. Emerging research has shown that the novel erector spinae plane (ESP) block, can be employed as a simple and safe alternative analgesic technique for acute post-surgical, post-traumatic and chronic neuropathic thoracic pain in adults. We illustrate this by presenting a paediatric case of VATS, in which an ESP block provided better analgesia, due to greater dermatomal coverage, as well as reduced side-effects when compared with a thoracic epidural that had previously been employed on the same patient for a similar procedure on the opposite side.


Erector spine block; epidural analgesia; local anaesthetic spread; video-assisted thoracoscopic surgery

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