Background and aims The erector spinae plane (ESP) block has been described as a novel regional anaesthetic technique for thoracic analgesia. In this case report we describe our experience with the insertion of ESP catheters in seven patients who underwent video-assisted thoracoscopic surgery for lobectomy.
Methods After induction of general anaesthesia, the ESP block was performed between T5 and T7 level with ultrasound guidance. Patients were administered a volume of 30 mL of local anaesthetic (mepivacaine 2% 15 mL and levobupivacaine 0.5% 15 mL), after which the catheter was placed in the same plane.
In the post-anaesthesia care unit (PACU) an ESP perfusion was started with Levobupivacaine 0,125% 8–10 mL/h plus standardized endovenous analgesia. Pain was evaluated with the visual analogic scale (VAS) from 0 to 10 in the PACU, 12, 24 and 48 hours postoperative as well as the need of rescue intravenous analgesia if VAS was greater than 3. On postoperative day 3 the catheter was removed.
Results Most of the patients reported a good level of analgesia with high satisfaction during their admission. Although some of them required rescue analgesia with opioids, all patients were able to complete their post-operative pulmonary rehabilitation with an adequate pain management. No complications related to the blocks were seen.
Conclusions ESP block seems to be a safe, easy and effective technique for thoracic surgery. Adding a catheter and a continuous infusion of local anaesthetic could be a good alternative for longer and more painful surgeries. Further studies are needed to compare the effectiveness with thoracic epidural and paravertebral block.
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