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Background and Aims Chronic pain represents a significant burden for patients, healthcare systems and society, given its impact on quality of life. Erector spinae plane block (ESPB) was rapidly adapted in clinical practice and numerous cases have been published presenting its effectiveness not only in acute but also in chronic pain.
Methods We present the case of a 39 year old patient with ovarian cancer who developed neuropathic thoracic pain after cytoreduction. She reported constant burning and stabbing neuropathic pain of 10/10 severity on the NRS pain scale, radiating from her spine into the anterior chest wall, mainly at T6 and extending several dermatomes inferiorly. She suffered from significant sleep disturbances and impairment of quality of life. Physical examination revealed allodynia and hyperesthesia over the affected dermatomes with a primary trigger point over the T6 dermatome, 3 to 4 cm lateral to the neuraxial midline. Pain management up to that point had included Pregabalin 300 mg, Tramadol 150mg, Paracetamol 3gr and Duloxetine 60mg daily at the time of consultation, with no improvement.
Results We performed a ESPB and we injected 0,2% Ropivacaine 20 ml. Within 20 minutes of the block, the patient had obtained complete relief of pain, with an NRS of 0/10 which lasted until now.
Conclusions The erector spinae block has gained attention as a potential option for chronic pain management, particularly for conditions involving the thoracic or lumbar spine. ESPB has shown promise in providing long-term pain relief in some cases of chronic neuropathic pain.
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