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Curr Pain Headache Rep. 2019 Aug 1;23(10):71. doi: 10.1007/s11916-019-0812-y.

Expanding Role of the Erector Spinae Plane Block for Postoperative and Chronic Pain Management.

Author information

1
Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA. iurits@bidmc.harvard.edu.
2
Georgetown University School of Medicine, Washington, DC, USA.
3
US Anesthesia Partners - Colorado, Denver, CO, USA.
4
Hospital for Special Surgery, New York City, NY, USA.
5
Creighton University School of Medicine, Omaha, NE, USA.
6
Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.
7
Department of Anesthesiology, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
8
Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA.
9
Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA.
10
Valley Anesthesiology and Pain Consultants, Phoenix, AZ, USA.

Abstract

PURPOSE OF REVIEW:

The erector spinae plane block (ESPB), first described in 2016, offers the promise of becoming a safe, less invasive, and technically less demanding alternative to conventional thoracic regional anesthetic techniques including thoracic epidurals and traditional paravertebral blocks. Clinical and cadaveric studies suggest that ESPB acts on the ventral rami of spinal nerves in the paravertebral space via penetration of the intertransverse connection tissues and moreover achieves visceral analgesia via the rami communicantes and sympathetic chain.

RECENT FINDINGS:

The block has garnered considerable appeal related to an inherently lower risk of neurovascular and pleural injury, low risk of local anesthetic systemic toxicity, and relative technical simplicity in comparison with epidural or paravertebral blockade. It has been utilized in the treatment of acute perioperative pain in a variety of clinical applications including breast, thoracic, and abdominal surgeries and trauma and may even offer some benefit in spine surgery. Given the combination of its efficacy and decreased associated risk when performed for perioperative pain, use of ESPB should be further explored for the management of chronic pain. Current literature at this time is limited to case studies and series performed by select groups. Though it is important to consider ESPB for chronic pain, further studies are needed to evaluate the efficacy and safety of the ESPB in the management of both acute and chronic pain.

KEYWORDS:

Chronic pain management; Erector spinae plane block; Perioperative analgesia; Regional anesthesia

PMID:
31372769
DOI:
10.1007/s11916-019-0812-y
[Indexed for MEDLINE]

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