Erector Spinae Plane Block. A narrative review

Carlos Eriel  Largo-Pineda; Daniela  González-Giraldo; Mario  Zamudio-Burbano

doi:10.5554/22562087.e1020

Carlos Eriel Largo-Pineda a. Anesthesiology, Universidad Militar Nueva Granada. Bogotá, Colombia. b. IPS Universitaria Clínica León XIII. Medellín, Colombia. https://orcid.org/0000-0002-5724-8248
Daniela González-Giraldo a. Anesthesiology, Universidad de Antioquia. Medellín, Colombia. b. IPS Universitaria Clínica León XIII. Medellín, Colombia. https://orcid.org/0000-0001-7800-1597
Mario Zamudio-Burbano a. Anesthesiology, Universidad de Antioquia. Medellín, Colombia. b. IPS Universitaria Clínica León XIII. Medellín, Colombia. https://orcid.org/0000-0001-8029-4974

DOI: https://doi.org/10.5554/22562087.e1020

Keywords: Nerve, block, Anesthesia and analgesia, Fascia, Anesthesia, conduction, Anatomy, regional

Abstract References How to Cite Downloads

Abstract

The erector spinae plane (ESP) block is an interfascial block described in 2016 by Forero and collaborators, with wide clinical uses and benefits when it comes to analgesic control in different surgeries. This block consists of the application of local anesthetic (LA) in a deep plane over the transverse process, anterior to the erector spinae muscle in the anatomical site where dorsal and ventral branches of the spinal nerve roots are located.

This review will cover its clinical uses according to different surgical models, the existing evidence and complications described to date.

References

Forero M, Adhikary SD, López H, Tsui C, Chin KJ. The erector spinae plane block a novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med. 2016;41(5):621-7. doi: http://www.doi.org/10.1097/AAP.0000000000000451

Chin KJ, Malhas L, Perlas A. The erector spinae plane block provides visceral abdominal analgesia in bariatric surgery a report of 3 cases. Reg Anesth Pain Med. 2017;42(3):372-6. doi: http://www.doi.org/10.1097/AAP.0000000000000581

Muñoz F, Cubillos J, Bonilla A, Chin KJ. Erector spinae plane block for postoperative analgesia in pediatric oncological thoracic surgery. Can J Anesth/J Can Anesth. 2017;10-2. doi: http://www.doi.org/10.1007/s12630-017-0894-0

Chin KJ, Adhikary S, Forero M. Is the erector spinae plane (ESP) block a sheath block ? A reply ‘Medicolegal’ or ‘patient-centred’ consent? Anaesthesia. 2017;72:910-24. doi: http://www.doi.org/10.1111/anae.13926

Adhikary S Das, Pruett A, Forero M, Thiruvenkatarajan V. Erector spinae plane block as an alternative to epidural analgesia for post operative analgesia following video assisted thoracoscopic surgery : A case study and a literature review on the spread of local anaesthetic in the erector spinae plane. Indian J Anaesth. 2018;62(1):83-6. doi: http://www.doi.org/10.4103/ija.IJA_693_17

Bonvicini D, Giacomazzi A, Pizzirani E. Use of the ultrasound-guided erector spinae plane block in breast surgery Use of the ultrasound-guided erector spinae plane block in breast surgery. Minerva anestesiol 2017. 2018;83(10):1111-2. doi: http://www.doi.org/10.23736/S0375-9393.17.12015-8

Hannig KE, Jessen C, Soni UK, Børglum J, Bendtsen TF. Case report erector spinae plane block for elective laparoscopic cholecystectomy in the ambulatory surgical setting. Case Rep Anesthesiol. 2018;2018:1-6. doi: https://doi.org/10.1155/2018/5492527

El-Boghdadly K, Pawa A. The erector spinae plane block: plane and simple. Anaesthesia. 2017;72:427-38. doi: http://www.doi.org/10.1111/anae.13830

Willard FH, Vleeming A, Schuenke MD, Danneels L, Schleip R. The thoracolumbar fascia: anatomy, function and clinical considerations. J Anat. 2012;507-36. doi: http://www.doi.org/10.1111/j.1469-7580.2012.01511.x

Benjamin M. The fascia of the limbs and back – a review. J Anat. 2009;(214):1-18. doi: http://www.doi.org/10.1111/j.1469-7580.2008.01011.x

Vleeming A, Pool-Goudzwaard A, Stoeckart R, van Wingerden J-P, Snijders CJ. The posterior layer of the thoracolumbar fascia. Spine (Phila Pa 1976). 1995;20(7):753-8.

Stecco A, Macchi V, Porzionato A, Masiero S, Tiengo C, Delmas V, et al. Pectoral and femoral fasciae: common aspects and regional specializations. Surg Radiol Anat. 2009;31:35-42. doi: http://www.doi.org/10.1007/s00276-008-0395-5

Barrios A, Camelo J, Gómez J, Forero M, Peng PWH, Visbal K, et al. Evaluation of sensory mapping of erector spinae plane block. Pain Physician. 2020;23(5):289-95.

De la Cuadra-Fontaine JC, Concha M, Vuletin F, Arancibia H. Continuous erector spinae plane block for thoracic surgery in a pediatric patient. Pediatr Anesth. 2018;28:74-5. doi: http://www.doi.org/10.1111/pan.13277

Nair AS, Seelam S, Naik V, Rayani BK. Opioid free mastectomy in combination with ultrasound guided erector spinae block : A series of five cases. Indian J Anaesth. 2018;62(8):632-4. doi: http://www.doi.org/10.4103/ija.IJA_314_18

Forero M, Rajarathinam M, Adhikary S, Chin KJ. Continuous erector spinae plane block for rescue analgesia in thoracotomy after epidural failure: a case report. A Case Reports. 2017;8(10):254-6. doi: http://www.doi.org/10.1213/XAA.0000000000000478

Hamilton DL, Manickam B. Erector spinae plane block for pain relief in rib fractures. Br J Anaesth. 2016;118(3):474-5. doi: http://www.doi.org/10.1093/bja/aex013

Chin KJ, Adhikary S, Sarwani N, Forero M. The analgesic efficacy of pre-operative bilateral erector spinae plane (ESP) blocks in patients having ventral hernia repair. Anaesthesia. 2017;72:452-60. doi: http://www.doi.org/10.1111/anae.13814

Wild K, Chin KJ. Regional techniques for thoracic wall surgery. Curr Anesthesiol Rep. 2017;7(2):212-9. doi: http://www.doi.org/10.1007/s40140-017-0212-y

Layera S, Bravo D, Aliste J. Bloqueos de tronco. Rev Chil Anest. 2020;49:65-78. doi: http://www.doi.org/10.25237/revchilanestv49n01.06

Ueshima H, Otake H. Erector spinae plane block for pain management of wide post-herpetic neuralgia. J Clin Anesth. 2018;51:37. doi: https://doi.org/10.1016/j.jclinane.2018.07.010

Forero M, Rajarathinam M, Adhikary S, Chin KJ. Erector spinae plane (ESP) block in the management of post thoracotomy pain syndrome: A case series. Scand J Pain. 2017;2-6. doi: http://dx.doi.org/10.1016/j.sjpain.2017.08.013

Ahiskalioglu A, Alici HA, Ciftci B, Celik M, Karaca O. Continuous ultrasound guided erector spinae plane block for the management of chronic pain. Anaesth Crit Care Pain Med. 2020;38(4):395-6. doi: http://dx.doi.org/10.1016/j.accpm.2017.11.014

Forero M, Rajarathinam M, Adhikary S Das, Chin KJ. Erector spinae plane block for the management of chronic shoulder pain: a case report. Can J Anesth/J Can Anesth. 2018;65(3):288-93. doi: http://www.doi.org/10.1007/s12630-017-1010-1

Wilson J, Lohser J, Klaibert B. Erector spinae plane block for postoperative rescue analgesia in thoracoscopic surgery to the editor. J Cardiothorac Vasc Anesth. 2018;32:5-7. doi: https://doi.org/10.1053/j.jvca.2018.06.026

Hu B, Zhou H, Zou X. The erector spinae plane block (ESPB) for non-intubated video-assisted thoracoscopic surgery. J Clin Anesth. 2019;54:50-1. doi: https://doi.org/10.1016/j.jclinane.2018.10.032

Luis Navarro JC, Seda Guzmán M, Luis Moreno C, López Romero JL. Bloqueo del plano del músculo erector de la columna en 4 casos de cirugía torácica videoasistida. Rev Esp Anestesiol Reanim. 2020;65(4):204-8. doi: https://doi.org/10.1016/j.redar.2017.12.004

Ciftci B, Ekinci M, Celik EC, Tukac IC, Bayrak Y, Atalay YO. Efficacy of an ultrasound-guided erector spinae plane block for postoperative analgesia management after video-assisted thoracic surgery : a prospective randomized study. J Cardiothorac Vasc Anesth. 2020;34:444-9. doi: https://doi.org/10.1053/j.jvca.2019.04.026

Gaballah KM, Soltan WA, Bahgat NM. Ultrasound-guided serratus plane block versus erector spinae block for postoperative analgesia after video-assisted thoracoscopy : a pilot randomized controlled trial. J Cardiothorac Vasc Anesth. 2020;33(2019):1946-53. doi: https://doi.org/10.1053/j.jvca.2019.02.028

Chen N, Qiao Q, Chen R, Xu Q, Zhang Y, Tian Y. The effect of ultrasound-guided intercostal nerve block, single-injection erector spinae plane block and multiple-injection paravertebral block on postoperative analgesia in thoracoscopic surgery: A randomized, double-blinded, clinical trial. J Clin Anesth. 2020;59:106-11. doi: https://doi.org/10.1016/j.jclinane.2019.07.002

Jhy Y, Gates S, Bv N, Mja W, F GS, Jhy Y, et al. Paravertebral block versus thoracic epidural for patients undergoing thoracotomy (Review). Cochrane Database Syst Rev. 2016;(2). doi: http://www.doi.org/10.1002/14651858.CD009121.pub2.

Raft J, Chin KJ, Belanger M, Clairoux A, Richebé P, Brulotte V. Continuous erector spinae plane block for thoracotomy analgesia after epidural failure. J Clin Anesth. 2019;54(September 2018):132-3. doi: https://doi.org/10.1016/j.jclinane.2018.10.024

Kelava M, Anthony D, Elsharkawy H. Continuous erector spinae block for postoperative analgesia after thoracotomy in a lung transplant recipient. J Cardiothorac Vasc Anesth. 2020;32(2018):2018-20. doi: https://doi.org/10.1053/j.jvca.2018.04.041

Nagaraja PS, Ragavendran S, Singh NG, Asai O, Bhavya G, Manjunath N, et al. Comparison of continuous thoracic epidural analgesia with bilateral erector spinae plane block for perioperative pain management in cardiac surgery. Ann Card Anaesth. 2018;21(3):323-7. doi: http://www.doi.org/10.4103/aca.ACA_16_18

Muñoz Leyva FM, Mendiola WE, Bonilla AJ, Cubillos J, Moreno DA, Chin KJ. Continuous Erector Spinae Plane ( ESP ) Block for Postoperative Analgesia after Minimally Invasive Mitral Valve Surgery. J Cardiothorac Vasc Anesth. 2020;32(2018):2271–4. doi: https://doi.org/10.1053/j.jvca.2017.12.020

Borys M, Gawęda B, Horeczy B, Kolowca M, Olszówka P, Czuczwar M. Erector spinae-plane block as an analgesic alternative in patients undergoing mitral and / or tricuspid valve repair through a right mini-thoracotomy – an observational cohort study. Videosurgery Other Miniinvasive Tech. 2020;1(March):208-14. doi: https://doi.org/10.5114/wiitm.2019.85396

Krishna SN, Chauhan S, Bhoi D, Kaushal B, Hasija S, Sangdup T, et al. Bilateral erector spinae plane block for acute post-surgical pain in adult cardiac surgical patients : a randomized controlled trial. J Cardiothorac Vasc Anesth. 2020;33(2019):368-75. doi: https://doi.org/10.1053/j.jvca.2018.05.050

Ueshima H, Otake H. Clinical experiences of ultrasound-guided erector spinae plane block for thoracic vertebra surgery. J Clin Anesth. 2017;38(August 2016):137. doi: http://dx.doi.org/10.1016/j.jclinane.2016.12.028

Canturk M. spondylolisthesis correction surgery. J Clin Anesth. 2020;57(February 2019):77-8. doi: https://doi.org/10.1016/j.jclinane.2019.03.015

Yayik AM, Cesur S, Ozturk F, Ahiskalioglu A, Ay AN, Celik EC, et al. Postoperative analgesic efficacy of the ultrasound-guided erector spinae plane block in patients undergoing lumbar spinal decompression surgery: a randomized controlled study. World Neurosurg. 2020;126:e779-85. doi: https://doi.org/10.1016/j.wneu.2019.02.149

Singh S, Choudhary NK, Lalin D, Verma VK. Bilateral ultrasound-guided erector spinae plane block for postoperative analgesia in lumbar spine surgery: a randomized control trial. J Neurosurg Anesth. 2020;32(4):330-4. doi: http://www.doi.org/10.1097/ANA.0000000000000603

Qiu Y, Zhang T, Hua Z. Erector spinae plane block for lumbar spinal surgery : a systematic review. J Pain Res. 2020;13:1611-9. doi: http://doi.org/10.2147/JPR.S256205

Aksu C, Kus A, Yorukoglu H, Tor Kilic C, Gurkan Y. Analgesic effect of the bi-level injection erector spinae plane block after breast surgery: A randomized controlled trial. Agri Pain. 2019;31:132-7. doi: http://www.doi.org/10.14744/agri.2019.61687

Swisher MW, Wallace AM, Sztain JF, Said ET, Khatibi B, Abanobi M, et al. Erector spinae plane versus paravertebral nerve blocks for postoperative analgesia after breast surgery: a randomized clinical trial. Reg Anesth Pain Med. 2020;0(2020):1-7. doi: http://www.doi.org/10.1136/rapm-2019-101013

Gürkan Y, Aksu C, Ku A, Yörüko UH. Erector spinae plane block and thoracic paravertebral block for breast surgery compared to IV-morphine: A randomized controlled trial. J Clin Anesth J. 2020;59:84-8. doi: https://doi.org/10.1016/j.jclinane.2019.06.036

Gürkan Y, Aksu C, Ku A, Yörüko UH, Cennet TK. Ultrasound guided erector spinae plane block reduces postoperative opioid consumption following breast surgery: A randomized controlled study. J Clin Anesth J. 2018;50(April):65-8. doi: https://doi.org/10.1016/j.jclinane.2018.06.033

Leong RW, Tan ESJ, Wong SN, Tan KH, Liu CW. Efficacy of erector spinae plane block for analgesia in breast surgery: a systematic review and meta-analysis. Anaesthesia. 2020:1-10. doi: http://www.doi.org/10.1111/anae.15164

Altıparmak B, Korkmaz M, İhsan A, Turan M. Comparison of the effects of modified pectoral nerve block and erector spinae plane block on postoperative opioid consumption and pain scores of patients after radical mastectomy surgery: A prospective , randomized, controlled trial. J Clin Anesth. 2019;54:61-5. doi: https://doi.org/10.1016/j.jclinane.2018.10.040

Gad K, Abdallah A, Abdelkhalek M, Abdelaziz M. Ultrasound-guided erector spinae plane block compared to modified pectoral plane block for modified radical mastectomy operations. Anesth Essays Res. 2019;13(2):334-9. doi: http://www.doi.org/10.4103/aer.AER_77_19.

Sinha C, Kumar A, Kumar A, Prasad C, Priya D. Pectoral nerve versus erector spinae block for breast surgeries: A randomised controlled trial. Indian J Anaesth. 2019;63:617-22. doi: https://doi.org/10.4103/ija.IJA_163_19, 10.4103/ija.IJA_163_19

El Ghamry MR, Amer AF. Role of erector spinae plane block versus paravertebral block in pain control after modified radical mastectomy. A prospective randomised trial. Indian J Anaesth [Internet]. 2019;63:1008-14. doi: https://doi.org/10.4103/ija.IJA_310_19, 10.4103/ija.IJA_310_19

Moustafa M, Alabd A, Ahmed A, Deghidy E. Erector spinae versus paravertebral plane blocks in modified radical mastectomy: Randomised comparative study of the technique success rate among novice anaesthesiologists. Indian J Anaesth. 2020;64(1):49-54. doi: http://www.doi.org/10.4103/ija.IJA_536_19

Sharma S, Arora S, Jafra A, Singh G. Efficacy of erector spinae plane block for postoperative analgesia in total mastectomy and axillary clearance : A randomized controlled trial. Saudi J Anesth. 2020;14(2):1-6. doi: http://www.doi.org/10.4103/sja.SJA_625_19

Singh S, Kumar G, Akhlleshwar. Ultrasound guided erector spinae plane block for postoperative analgesia in modified radical mastectomy: A randomised control study Address. Indian J Anaesth. 2019;63(3):42–6. doi: http://www.doi.org/10.4103/ija.IJA_758_18

Yao Y, Li H, He Q, Chen T, Wang Y, Zheng X. Efficacy of ultrasound- guided erector spinae plane block on postoperative quality of recovery and analgesia after modified radical mastectomy : randomized controlled trial. Reg Anesth Pain Med. 2019;0:1-5. doi: http://www.doi.org/10.1136/rapm-2019-100983.

Altiparmak B, Toker M, Uysal A, Demirbilek S. Comparison of the efficacy of erector spinae plane block performed with different concentrations of bupivacaine on postoperative analgesia after mastectomy surgery: ramdomized, prospective, double blinded trial. BMC Anesthesiol. 2019;19(32):1-9. doi: https://doi.org/10.1186/s12871-019-0700-3

Oksuz G, Bilgen F, Arslan M, Duman Y. Ultrasound-guided bilateral erector spinae block versus tumescent anesthesia for postoperative analgesia in patients undergoing reduction mammoplasty: a randomized controlled study. Aesth Plast Surg. 2019;43:291-6. doi: https://doi.org/10.1007/s00266-018-1286-8

Tulgar S, Selvi O, Kapakli MS, Reports C. Case report erector spinae plane block for different laparoscopic abdominal surgeries: case series. Case Rep Anesthesiol. 2018;2018:8-10. doi: http://www.doi.org/10.1155/2018/3947281

Altıparmak B, Korkmaz M, Ihsan A, Kuşçu Y. Ultrasound-guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: Randomized, controlled trial. J Clin Anesth. 2019;57 (December 2018):31-6. doi: https://doi.org/10.1016/j.jclinane.2019.03.012

Tulgar S, Kapakli MS, Kose HC, Senturk O, Selvi O, Serifsoy TE, et al. Evaluation of ultrasound guided erector spinae plane block and oblique subcostal transversus abdominis plane block in laparoscopic cholecystectomy: randomized, controlled, prospective study. Anesth Essays Res. 2019;13(1):50-6. doi: http://www.doi.org/10.4103/aer.AER_194_18

Tulgar S, Sertan M, Senturk O, Selvi O, Ercan T. Evaluation of ultrasound-guided erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy: A prospective, randomized , controlled clinical trial. J Clin Anesth. 2018;49(April):101-6. doi: https://doi.org/10.1016/j.jclinane.2018.06.019

Kwon H, Kim D, Jeong S, Choi KT, Park S, Kwon H, et al. Does erector spinae plane block have a visceral analgesic effect ?: a randomized controlled trial. Sci Rep. 2020;10(8389):1-8. doi: http://dx.doi.org/10.1038/s41598-020-65172-0

Altinpulluk EY, Simón DG. Bloqueo del plano del erector del espinal para analgesia tras cesárea del segmento inferior: informe de caso. Rev Esp Anestesiol Reanim. 2020;65(5):284-6. doi: https://doi.org/10.1016/j.redar.2017.11.006

Restrepo-Garcés CE, Chin KJ, Hons M, Suárez P, Díaz A. Bilateral continuous erector spinae plane block contributes to effective postoperative analgesia after major open abdominal surgery: a case report. A A Case Reports. 2017;9(11):319-21. doi: http://www.doi.org/10.1213/XAA.0000000000000605

Gaio-lima C, Costa CC, Moreira JB, Lemos TS, Trindade HL. Bloqueo continuo en el plano del músculo erector del espinal para analgesia en cirugía torácica pediátrica: informe de un caso A case report. Rev Esp Anestesiol Reanim. 2020;65(5):287-90. doi: https://doi.org/10.1016/j.redar.2017.11.010

Nardiello MA, Herlitz M. Bloqueo bilateral del plano del músculo erector de la columna espinal para cirugía de pectus excavatum y pectus carinatum en 2 pacientes pediátricos. Rev Esp Anestesiol Reanim. 2018;65(9):530-3. doi: https://doi.org/10.1016/j.redar.2018.04.006

Aksu C, Gurkan Y. Ultrasound-guided bilateral erector spinae plane block could provide effective postoperative analgesia in laparoscopic cholecystectomy in paediatric patients. Anaesth Crit Care Pain Med. 2020;38(2019):87-8. doi: https://doi.org/10.1016/j.accpm.2018.03.008

Hernández MA, Palazzi L, Lapalma J, Cravero J. Erector spinae plane block for inguinal hernia repair in preterm infants. Pediatr Anesth. 2018;00(December 2017):2017-8. doi: https://doi.org/10.1111/pan.13325

Tulgar S, Senturk O. Ultrasound guided Erector Spinae Plane block at L-4 transverse process level provides effective postoperative analgesia for total hip arthroplasty. J Clin Anesth. 2018;44:68. doi: https://doi.org/10.1016/j.jclinane.2017.11.006

Bugada D, Zarcone AG, Manini M, Lorini LF. Continuous erector spinae block at lumbar level (L4) for prolonged postoperative analgesia after hip surgery. J Clin Anesth. 2018;52:24-5. doi: https://doi.org/10.1016/j.jclinane.2018.08.023

Darling CE, Pun SY, Caruso TJ, Tsui BCH. Successful directional thoracic erector spinae plane block after failed lumbar plexus block in hip joint and proximal femur surgery. J Clin Anesth. 2018;49(April 2018):1-2. doi: https://doi.org/10.1016/j.jclinane.2018.05.002

Balaban O, Aydın T. Lumbar erector spinae plane catheterization for continuous postoperative analgesia in total knee arthroplasty : A case report. J Clin Anesth. 2019;55:138-9. doi: https://doi.org/10.1016/j.jclinane.2018.12.017

Ueshima H. Pneumothorax after the erector spinae plane block. J Clin Anesth. 2018;48(April 2018):12. doi: https://doi.org/10.1016/j.jclinane.2018.04.009

Elkoundi A, Eloukkal Z, Bensghir M, Belyamani L. Priapism following erector spinae plane block for the treatment of a complex regional pain syndrome. Am J Emerg Med. 2019;37(4):796.e3-796.e4. doi: https://doi.org/10.1016/j.ajem.2019.01.012

Selvi O, Tulgar S. Bloqueo en el plano del erector de la columna ecoguiado como causa de bloqueo motor imprevisto. Rev Esp Anestesiol Reanim. 2018;65(10):589-92. doi: https://doi.org/10.1016/j.redar.2018.05.009

Sondekoppam RV, Tsui BCH. Factors associated with risk of neurologic complications after peripheral nerve blocks. Anesth Analg. 2017;124(2):645-60. doi: http://www.doi.org/10.1213/ANE.0000000000001804

Tulgar S, Selvi O, Ultrasound-guided erector spinae plane block: indications, complications, and effects on acute and chronic pain based on a single-center experience. Cureus. 2019;11(1):e3815. doi: http://www.doi.org/10.7759/cureus.3815

How to Cite

1.

Largo-Pineda CE, González-Giraldo D, Zamudio-Burbano M. Erector Spinae Plane Block. A narrative review. Colomb. J. Anesthesiol. [Internet]. 2022 Jan. 3 [cited 2024 Apr. 18];50(4). Available from: https://www.revcolanest.com.co/index.php/rca/article/view/1020