Background and aims The erector spinae plane (ESP) block is an interfascial plane block where a local anaesthetic is injected in a plane preferably below the erector spinae muscle. It is supposed to work at the origin of spinal nerves. In this case series, we attempted to examine the effectiveness of ESP blocks as regional anesthesia for breast cancer incisional biopsy.

Methods Ten patients, aged 55 to 66 years old, diagnosed with suspected malignant breast cancer, were underwent open biopsy for diagnostic purposes. We attempted to use ultrasound guided ESP block as regional anesthesia. Firstly, we identified musculus erector spinae at 3cm lateral of vertebrae T5 level at seated position. Then, local anesthetic 20cc of ropivacaine 0.375% were injected through needle at the plane below the musculus erector spinae. the local anesthetic spreading below the musculus erector spinae could be visualized by ultrasound. We achieved complete block over T3 to T7 hemi thorax within 30 minutes.

Results We successfully administered the regional anesthesia ESP block to nine of ten patients. They also had pain numerical rating scale of 0–2/10 for 48 hours post operative. However, one patient did not get adequate block result and we had to use general anesthesia instead.

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Abstract ESRA19-0646 Figure 1

Conclusions ESP block may be used as an alternative regional anesthesia technique for breast cancer open biopsy procedure, but further research needs to be done to prove its effectiveness and reliability.