Background and aims Research has shown that erector spinae plane (ESP) block can be used as safe analgesic technique for acute and chronic neuropathic pain. For recurrent pain, ESP block can be administered through a catheter giving a long term analgesic effect. We present a case of catheterized ESP block as a pain management modality for pulmonary bronchogenic cancer pain.
Methods A 46-year-old woman, diagnosed with pulmonary bronchogenic carcinoma, had severe stabbing neuropathic pain with a 9/10 severity on the numerical rating score (NRS). the pain didn’t subside significantly even after we administered intravenous fentanyl 50mcg/hour, 1g paracetamol every 6 hours, and 12,5mg amitriptyline every 24 hours. We decided to use ESP block due to inadequate pain control for this patient. Using an ultrasound guided technique, we inserted a catheter to the interfascial plane below the musculus erector spinae and injected local anesthetic periodically. We used 20cc bupivacaine 0.125% every 12 hours.
Results The patient had significant decrease of pain, with numerical rating scale from 5–6/10 at first 12 hours to 1–2/10 at 48 hours. We evaluated that satisfactory pain control was achieved and maintained after 48 hours after first local anesthetic administration.
Conclusions Periodical administration of ESP block can be used as an effective alternative pain intervention for patient with severe cancer pain with inadequate pain control by high dose opioid.
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