The Use of the Erector Spinae Plane Block to Decrease Pain and Opioid Consumption in the Emergency Department: A Literature Review

Abstract

Background: Acute pain represents one of the most common reasons for emergency department (ED) visits. In the opioid epidemic that North America faces, there is a significant demand for novel effective pain control modalities, especially in the acute setting.

Objectives: The goal of this study was to review all the indications and summarize the efficacy of the Erector Spinae Plane Block (ESPB) in the ED.

Methods: PubMed, EMBASE, and MEDLINE, as well as CINAHL databases were searched according to the PRISMA guidelines to find any study reporting on the use of ESPB in the ED.

Results: Ten studies were published reporting on seven different indications for the use of ESPB in the ED. It was most commonly used for rib and spine fractures. Other indications included: mechanical pain, burn injuries, herpes zoster, renal colic, and acute pancreatitis. All the studies demonstrated a significant reduction in pain after administration of ESPB. Furthermore, it has been reported to improve respiratory function and was not associated with any complications after administration.

Conclusions: ESPB is an easy-to-administer interfascial plane block that has several indications and promising potential for acute pain management in the ED. The easily identified landmarks coupled with its low complication rate makes it an appealing technique to be used by emergency physicians in the context of acute pain management. Further studies should investigate any other possible indications and compare its efficacy with other techniques, such as epidurals and serratus anterior blocks.

Keywords: emergency medicine; erector spinae plane block; opioid addiction; pain management; regional anesthesia.