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Saudi J Anaesth. 2019 Jul-Sep;13(3):253-254. doi: 10.4103/sja.SJA_186_19.

Erector spinae plane block unbound: Limits to safety in a patient with laminectomy.

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Division of Regional Anesthesia and Acute Pain Management, Department of Anesthesiology, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.


The erector spinae plane (ESP) block has been used to provide analgesia for multiple surgeries involving the abdomen and thorax. Like other plane blocks, the ESP block relies upon normal anatomical boundaries for predictable and safe distribution of local anesthetic. Surgical intervention can alter the anatomy and present new considerations for performing plane blocks. We present a case in which an ESP block was performed for multiple rib fractures in a patient with a recent laminectomy. Laminectomy patients present unique considerations regarding the safety of the ESP block.


Acute pain management; Trauma; erector spinae plane block; laminectomy; patient safety; postoperative pain control; rib fracture

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