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Background and Aims Opioid use can cause side effects like nausea, vomiting, constipation, respiratory depression, urinary retention. The erector spinae plane (ESP) block is a regional analgesia technique that reduces the perioperative administration of opioids and their side effects.

Methods A 63-year-old woman presented to the emergency department complaining of abdominal pain and vomiting. Chest X-ray and Computerized Tomography (CT) scan were performed and revealed a gastric volvulus. In the operating room, pulse oximetry, electrocardiogram and non-invasive blood pressure were placed. With the patient in a sitting position, ultrasound-guided ESP block was performed and 20ml of 1% mepivacaine with 0.25% levobupivacaine were infiltrated between the transverse process of T5. Anaesthesia was induced and the patient was intubated. Propofol infusion was started, and the reduction of the volvulus was achieved without complications. Paracetamol 1gr, dexketoprofen 50mg and ondansetron 4mg iv were administered. She was admitted to the post-anaesthesia care unit (PACU), with a Visual Analog Scale (VAS) score of 0. She was discharged to the ward after five hours without complications.

Results Peri-operative nausea and vomiting can be exacerbated with the use of opioids. It is important to treat it aggressively due the risk of aspiration. ESP block is an anaesthetic option that can avoid these problems.

Conclusions ESP block is an easy, simple, and safe regional technique that has demonstrated good results in the management of these kind of patients.