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Abstract
Background and aims The erector spinae plane block (ESPB) was first described in 2016, and, since then, there has been growing interest and research about its potential as a regional anesthetic/analgesic technique. With the present case we are interested in exploring the efficacy of ESPB as a postoperative analgesic method for laparoscopic hysterectomy.
Methods We describe a case of a 47-year-old female patient, ASA I, scheduled for elective laparoscopic hysterectomy. A bilateral ultrasound-guided ESP block at T8 level was performed before general anesthesia induction. The anesthetic solution we used consisted of 20 ml Ropivacaine 0,5% (on each side). Systemic analgesia with Paracetamol 1 g and Ketorolac 30 mg was performed during the surgery and prescribed for 24h and after that ‘on demand’.
Results Procedure and recovery were uneventful, with the patient experiencing good analgesia (NRS pain scale 0–2/10) 12 hours after block performance. No ‘on demand’ pain medication was requested by the patient during the hospital admission. The patient experienced no nausea or vomiting, was mobilized easily 6 hours after the block and was discharged 36 hours later.
Conclusions The ESP block applied to abdominal laparoscopic surgery has a relatively limited literature, particularly in laparoscopic hysterectomy. This is the reason we believe every new case is a valuable contribution. In this case report, the use of ESPB performed preoperatively dramatically reduced the amount of IV pain medication. The overall result was increased satisfaction of the patient, avoidance of opioid use and fast recovery.