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

Current Pain and Headache Reports
Ivan UritsOmar Viswanath

Abstract

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. 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 t...Continue Reading

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Citations

Sep 27, 2020·Pain Practice : the Official Journal of World Institute of Pain·Mohamed Aziz DaghmouriKamel Ben Fadhel
Aug 15, 2020·Anesthesiology Clinics·Charlotte M WalterVanessa A Olbrecht
May 14, 2021·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Jun MaBin Liu
Aug 27, 2021·Clinical Practice and Cases in Emergency Medicine·Daniel H LeeRobert F Reardon

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