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Background and Aims The sacral erector spinae plane (ESP) block is a promising technique for managing postoperative pain in perineal procedures. It involves injecting a single dose of medication into the midline, which can provide bilateral pain relief. This technique has been shown to be effective in multiple case reports, with some suggesting that it may be as effective as neuraxial anesthesia

Methods Retrospective analysis.

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Abstract #34496 Figure 1

Sacral ESP Block

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Abstract #34496 Figure 2

Sacral Anatomy

Results We present a case study of a 17-year-old male patient who underwent biopsy and resection of a cystic sacral mass under general anesthesia with sacral ESP block for pain management. The procedure was performed using ultrasound guidance, and the patient did not require any additional narcotics during the surgery. Following the procedure, the patient reported no pain and did not require any opioids or pain medications during his recovery at home.

Conclusions This case highlights the potential benefits of using sacral ESP block as a part of multimodal anesthesia in perineal procedures. While central techniques are commonly used for this type of surgery, peripheral blocks like sacral ESP block may be a viable alternative for patients who are not candidates for central blockade. By reducing the need for opioids, this technique has the potential to decrease the length of stay in the PACU and increase overall patient satisfaction.