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Abstract
Background and Aims We report a case of continuous Erector spinae block for pain relief and successful weaning of patient from mechanical ventilation with multiple rib fractures
Methods After getting informed consent under all aseptic precaution and after attaching all standard monitors an erector spinae block was performed at the level of T5 transverse process using Sonosite 6–13MHz 38mm linear probe in plane technique.18 G touhys needle was used and once the T5 transverse process was hit using USG guidance after negative aspiration 15 ml of 0.2% ropivacaine was given as bolus and 20G epidural catheter was inserted around 5 ml of 0.2%ropivacaine was used to hydrodissect and cathter was threaded without any resistance and the local anesthetic spread was confirmed using USG . We kept the catheter tip around 4 cm inside and the catheter was tunnelled and fixed over the skin .
Results We reassessed the patient after half an hour and we could find his breathing pattern has improve and we could find his pain has relived .he was extubated and we formally assessed the distribution of cutaneous dermatomal block . We could find loss of cold sensation of hemithorax from T1 to T9.We also assessed the pain score at rest and after cough.Numerical pain score was 0/10 at rest and 1/10 after coughing
Conclusions Early pain relief in case of rib fracture will prevent respiratory morbidities and the regional anesthesia techniques play a crucial role in this regard. . Continous ESPB is a novel ,simple technique with less complication and with intense and rapid analgesia.