Mauricio Forero1, Manikandan Rajarathinam2, Sanjib Das Adhikary3, Ki Jinn Chin4. 1. Department of Anesthesia, McMaster University, Hamilton, ON, Canada. 2. Department of Anesthesia, Western University, London, ON, Canada. 3. Department of Anesthesia, Penn State Hershey Medical Center, Hershey, PA, USA. 4. Department of Anesthesia, University of Toronto, Toronto Western Hospital, McL 2-405, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada. gasgenie@gmail.com.
Abstract
PURPOSE: The erector spinae plane (ESP) block has been described in the successful management of both thoracic and abdominal pain. Since the erector spinae muscle extends to the cervical spine, the ESP block may be potentially useful in painful conditions of the shoulder girdle. CLINICAL FEATURES: We performed a series of ESP blocks at the T2/T3 level in an elderly male patient with chronic shoulder pain. Immediate and profound analgesia with improved range of motion was consistently observed following the block. There was detectable sensory block in the congruent cervico-thoracic dermatomes with no motor block. Computed tomography imaging showed the spread of radiocontrast up to the C3 level in the vicinity of the neural foramina. Clinical analgesia generally outlasted the expected duration of conduction blockade and significantly contributed to overall improvement in the patient's symptoms. CONCLUSIONS: The ESP block may be a promising alternative to other interventional procedures in the management of chronic shoulder pain and deserves further study.
PURPOSE: The erector spinae plane (ESP) block has been described in the successful management of both thoracic and abdominal pain. Since the erector spinae muscle extends to the cervical spine, the ESP block may be potentially useful in painful conditions of the shoulder girdle. CLINICAL FEATURES: We performed a series of ESP blocks at the T2/T3 level in an elderly male patient with chronic shoulder pain. Immediate and profound analgesia with improved range of motion was consistently observed following the block. There was detectable sensory block in the congruent cervico-thoracic dermatomes with no motor block. Computed tomography imaging showed the spread of radiocontrast up to the C3 level in the vicinity of the neural foramina. Clinical analgesia generally outlasted the expected duration of conduction blockade and significantly contributed to overall improvement in the patient's symptoms. CONCLUSIONS: The ESP block may be a promising alternative to other interventional procedures in the management of chronic shoulder pain and deserves further study.
Authors: Pablo Kot; Pablo Rodriguez; Manuel Granell; Beatriz Cano; Lucas Rovira; Javier Morales; Ana Broseta; Jose De Andrés Journal: Korean J Anesthesiol Date: 2019-03-19
Authors: Adriana Aponte; Xavi Sala-Blanch; Alberto Prats-Galino; Joseph Masdeu; Luis A Moreno; Luc A Sermeus Journal: Can J Anaesth Date: 2019-05-21 Impact factor: 5.063