ESP-block in thoracic surgery: a case report

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This report presents a clinical case of combined anesthesia in a patient with videothoracoscopic atypical resection of the right lung. In the operating room, the patient underwent ultrasound-assisted blockade in the plane of the m. erector spinae (ESP block) using 20 mL of 0.375% levobupivacaine solution, after which general anesthesia was induced. Opioid consumption per surgery was 0.3 mg of fentanyl. In the postoperative period, high-quality multimodal pain relief was achieved without the use of opioids. Within 7 h after the operation, the patient could actively expectorate with minimal discomfort. The article demonstrates the possibility of the effective application of the ESP block to reduce the risk of respiratory complications during lung surgery and to prevent the development of neuropathic post-thoracotomy pain syndrome.

作者简介

Anatoliy Stukalov

S.M. Kirov Military Medical Academy

编辑信件的主要联系方式.
Email: zamkom-vma@mail.ru
ORCID iD: 0000-0002-3869-9043
SPIN 代码: 9636-6856

Researcher

俄罗斯联邦, 6, Academica Lebedeva st., Saint Petersburg, 194044

Roman Lakhin

S.M. Kirov Military Medical Academy

Email: doctor-lahin@yandex.ru
ORCID iD: 0000-0001-6819-9691
SPIN 代码: 7261-9985

MD., Professor

俄罗斯联邦, 6, Academica Lebedeva st., Saint Petersburg, 194044

Evgeniy Ershov

S.M. Kirov Military Medical Academy

Email: ershov.en@gmail.com
ORCID iD: 0000-0002-9572-6802

Ph.D.

俄罗斯联邦, 6, Academica Lebedeva st., Saint Petersburg, 194044

参考

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  2. Kot P, Rodriguez P, Granell M, et al. The erector spinae plane block: a narrative review. Korean J Anesthesiol. 2019;72(3):209–220. doi: 10.4097/kja.d.19.00012
  3. De Cassai A, Bonvicini D, Correale C, et al. Erector spinae plane block: a systematic qualitative review. Minerva Anestesiol. 2019;85(3):308–319. doi: 10.23736/S0375-9393.18.13341-4
  4. Gurkan Y, Aksu C, Kus A, et al. Ultrasound guided erector spinae plane block reduces postoperative opioid consumption following breast surgery: A randomized controlled study. J Clin Anesth. 2018;50:65–68. doi: 10.1016/j.jclinane.2018.06.033
  5. Forero M, Adhikary SD, Lopez H, et al. The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain. Reg Anesth Pain Med. 2016;41(5):621–627. doi: 10.1097/AAP.0000000000000451
  6. Chin KJ, El-Boghdadly K. Mechanisms of action of the erector spinae plane (ESP) block: a narrative review. Can J Anaesth. 2021. doi: 10.1007/s12630-020-01875-2
  7. Pirsaharkhiz N, Comolli K, Fujiwara W, et al. Utility of erector spinae plane block in thoracic surgery. J Cardiothorac Surg. 2020;15(1):91. doi: 10.1186/s13019-020-01118-x
  8. Novak-Jankovic V, Markovic-Bozic J. Regional Anaesthesia in Thoracic and Abdominal Surgery. Acta Clin Croat. 2019;58(Suppl 1): 96–100. doi: 10.20471/acc.2019.58.s1.14
  9. Adhikary SD, Pruett A, Forero M, Thiruvenkatarajan V. 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. Indian J Anaesth. 2018;62(1):75–78. doi: 10.4103/ija.IJA_693_17
  10. Arends S, Bohmer AB, Poels M, et al. Post-thoracotomy pain syndrome: seldom severe, often neuropathic, treated unspecific, and insufficient. Pain Rep. 2020;5(2):e810. doi: 10.1097/PR9.0000000000000810

补充文件

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1. JATS XML
2. Fig. 1. Ultrasound picture of the musculoskeletal-ligamentous complex of the back (T – trapezius muscle, RM – rhomboid muscle, ESM – erector spine muscle, TP – transverse process, P – pleura, N – needle)

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3. Fig. 2. Zone of the sensor block unit 7 hours after surgery

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