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Background and Aims The erector spinae plane block (ESP), was described in 2016. ESP block technique involves ultrasound-guided injection of volume of local anesthetic into the fascial plane between the tips of the vertebral transverse processes and erector spinae muscle. Local anesthetic spreads over 3–6 vertebral levels in a craniocaudal direction. Snapping scapula or scapulothoracic syndrome occurs due to disruption of the smooth gliding motion between scapula and thoracic cage. It can be chronic and very disabling for patients. The patient population is commonly young and active presented with pain in the scapulothoracic area aggravated by overhead and repetitive shoulder movements.
Methods Women, 54 yo no past medical history, more than 8 months suffering right disabling scapula pain and clicking in the superior medial border of the scapula. No good results to non-operative management. VAS 9/10. Positive response to corticosteroid and local anesthetic injection. Was programmed for scapulothoracic arthroscopy under general anesthesia ‘chicken wing’ position adding preoperative ESP block T4 for multimodal analgesia with 0.25% 25ml Levobupivacaine and dexamethasone 4mg.
Results VAS was recorded in time1 (1h postsurgery in PACU) 1/10, time2 (6h postsurgery) 1/10 and time3 (20h postsurgery, before discharche) 3/10. Three months later patient showed improvement in VAS versus preoperative situation and also in quality and range of movement.
Conclusions We can conclude that in this patient adding to common 1st step intravenous analgesia ESP block, was a good option in terms of quality of analgesia and patient comfort without complications, but is necessary studies to recommend ESP block for this surgeries.
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