A magnetic resonance imaging study of local anesthetic spread in patients receiving an erector spinae plane block.

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
Ana SchwartzmannMauricio Forero

Abstract

Despite the popularity of the erector spinae plane (ESP) block, both the mechanism of the block and the extent of injectate spread is unclear. This study used magnetic resonance imaging (MRI) to evaluate the spread of local anesthetic injectate following ESP blocks in six patients with pain. Six patients received a left-sided ultrasound-guided ESP block at the T10 level. The injectate contained 29.7 mL of 0.25% bupivacaine and 0.3 mL of gadolinium in the first patient, with an additional 5 mL (50 mg) of triamcinolone in the subsequent five patients. Sensory block to pinprick and cold as well as pain score (with 0 indicating no pain and 10 being maximum pain) were assessed 20 and 30 min respectively following the ESP block. MRI was performed one hour after the block. The injectate spread into the intercostal space and neural foramina in all six patients, but the extent of cephalocaudal spread was variable, with a median [interquartile range] spread of 9 [5-11] and 3 [2-6] levels for the intercostal space and neural foramina, respectively. The injectate also spread extensively within the erector spinae muscles. Spread to the epidural space was seen in two patients. Sensory block was achieved in both ventral and dorsal dermatomes ...Continue Reading

References

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Nov 15, 2017·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Mauricio ForeroKi Jinn Chin
May 11, 2018·Regional Anesthesia and Pain Medicine·Jason IvanusicMichael J Barrington
Aug 5, 2018·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Ana SchwartzmannMauricio Forero
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Citations

Apr 11, 2020·Regional Anesthesia and Pain Medicine·Yasuko Taketa, Taro Fujitani
Mar 28, 2020·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Patricia PapaJuan-Francisco Asenjo
Nov 19, 2020·Regional Anesthesia and Pain Medicine·Mauricio Forero
Jan 7, 2021·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Ki Jinn Chin, Kariem El-Boghdadly
Jun 20, 2021·Regional Anesthesia and Pain Medicine·Ki Jinn ChinMiguel A Reina
Jun 20, 2021·Regional Anesthesia and Pain Medicine·David H KimStavros G Memtsoudis
Jun 20, 2021·Regional Anesthesia and Pain Medicine·Ki Jinn ChinStephan K W Schwarz
Jul 10, 2021·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Dina Ahmed El MallaMona Blough El Mourad
Nov 16, 2021·Journal of Anesthesia·Kunihisa Hotta

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