Erector Spinae Plane Blocks in Major Hepatopancreaticobiliary Surgery: A Case Series

A A Pract. 2019 Nov 1;13(9):332-334. doi: 10.1213/XAA.0000000000001069.

Abstract

Hepatopancreaticobiliary (HPB) surgery is major upper abdominal surgery with considerable risk of pulmonary complications related to postoperative pain. While epidural analgesia remains an effective analgesic technique for upper abdominal surgery, HPB surgery poses challenges to its use due to coagulopathy. Erector spinae plane (ESP) blocks are a promising alternative to epidurals. Injection of local anesthetic deep to the erector spinae muscle plane and placement of a catheter for prolonged effect provide both somatic and visceral analgesia for both thoracic and abdominal surgery. We describe a series of 3 cases that illustrate the efficacy of ESP blocks after major HPB surgery.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Analgesia
  • Anesthetics, Local
  • Bupivacaine
  • Female
  • Humans
  • Liver / surgery
  • Male
  • Middle Aged
  • Nerve Block*
  • Pancreas / surgery
  • Paraspinal Muscles*
  • Postoperative Pain / therapy*
  • Spinal Nerves*
  • Young Adult

Substances

  • Anesthetics, Local
  • Bupivacaine