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Abstract
Background and aims The erector spinae plane block (ESPB) is a new interfascial plane block that has recently been increasing in popularity. Most anatomic and clinical studies have evaluated ESPB applied at upper thoracic region were evaluated. Herein, we aimed to investigate the presence of sensory blocks in different compartments in the thoracoabdominal region by pinprick test in patients who underwent bilateral ESPB from thoracic (Th)9 level.
Methods Clinical trial regeneration was performed (NCT03744520) and the study was started in November 2018. Written informed consent was obtained from all patients for procedures, dermatomal analysis and publishing. Bilateral ESPB with 30 mL 0.25% bupivacaine was applied in abdominal surgery patients and sensory analysis was performed with pinprick test 3 hours after block application. In the sensory analysis, each dermatome was evaluated separately. They were also divided into four quadrants: dorsomedial-dorsolateral, ventral-lateral and ventromedial, from the posteromedial to the front.
Results A total of 25 patients underwent 50 ESPBs. 3 blocks were evaluated as sensory failure in all four quadrants. Dorsomedially 10, dorsolaterally 13, ventral-laterally 6 and ventral-medially 15 blocks were accepted as failed block. the sensory features of the blocks are shown in figure 1. Only half of the applications were able to block 4 quadrants between Th7-Th10. There was a significant difference between the right and left block distributions (IRR <0.30).
Conclusions The ESPB applied at T9 level shows different block characteristics in varying dorsal and ventral quadrants. the success of sensory block in the mid-abdominal and parasternal regions are relatively low.