Background and aims Through its action on the dorsal rami, the cervical erector spinae plane block (ESPB) seems to provide extensive analgesia and rapid recovery in the postoperative period after spine surgeries. We describe bilateral cervical ESPB with continuous infusion in the ESP in 4 patients who underwent posterior cervical decompression and stabilization for various surgical indications.
Methods After obtaining informed consent, 4 ASA-PS 1–3 patients [46–70 years, M=3; F = 1] who underwent posterior cervical decompression were enrolled in this study. Standard general anaesthesia technique was used for all 4 patients, airway was secured with endotracheal tube and patients were made prone. Using a linear array ultrasound (US) probe, bilateral ESPB was performed at T3 vertebral level and 20 ml of 0.2% ropivacaine and 25 μg of dexmedetomidine was injected bilaterally. 20 G catheters were inserted to a depth of 6–7 cm in the ESP on both sides. All patients received 1 gm IV paracetamol 8th hourly and 5 ml/hr infusion of 0.1% ropivacaine i.e. 10 ml/hr bilaterally for 48 hrs. IV tramadol 100 mg was the rescue analgesic planned if VAS score observed was more than 4. After an informed consent CT contrast study was performed in 2 patients to understand the spread of injectate.
Results No patient required rescue analgesia for 48 hours and VAS score was in the range of 1–2. The contrast spread is described in detail in table 1.
Conclusions Bilateral cervical ESPB block and continuous infusion provides good quality, opioid sparing analgesia after posterior cervical spine decompression surgeries.
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