Continuous erector spinae plane block for pain management in laparoscopic liver resection: case report

  • Cristiano Piangatelli Anesthesia and Intensive Care of Transplantation and Major Surgery, Department of Emergency, Ospedali Riuniti Ancona, Ancona, Italy
  • Enrico Dalla Bona Hepatobiliary and Abdominal Transplantation Surgery, Department of Gastroenterology and Transplantation, Marche Polytechnic University, Ancona, Italy
  • Diego Tavoletti Clinic of Anesthesia and Intensive Care Unit, Department of Emergency, Ospedali Riuniti, Marche Polytechnic University, Ancona, Italy
  • Elisabetta Rosanò Clinic of Anesthesia and Intensive Care Unit, Department of Emergency, Ospedali Riuniti, Marche Polytechnic University, Ancona, Italy
  • Federico Mocchegiani Hepatobiliary and Abdominal Transplantation Surgery, Department of Gastroenterology and Transplantation, Marche Polytechnic University, Ancona, Italy
  • Marco Vivarelli Hepatobiliary and Abdominal Transplantation Surgery, Department of Gastroenterology and Transplantation, Marche Polytechnic University, Ancona, Italy
  • Elisabetta Cerutti Anesthesia and Intensive Care of Transplantation and Major Surgery, Department of Emergency, Ospedali Riuniti Ancona, Ancona, Italy
Keywords: Erector spinae plane block, Hepatectomy, Liver resection, Parkinson’s disease

Abstract

Pain after liver resection can be difficult to manage. Epidural anesthesia (EA) isaneffective technique inpain control inthis surgery.

However, postoperative coagulopathy and hypotension due to autonomic nervous system block in high-risk patients, may result that the EA is an inadequate analgesic technique in according to enhanced recovery after surgery (ERAS) recommendations for liver surgery.

Regional block techniques have been recommended for liver surgery in ERAS guidelines.

Erector spinae plane (ESP) block is a recent block described for thoracic and abdominal surgeries and provides both somatic and visceral analgesia.

We describe a high-risk patient with cardiac dysfunction and Parkinson’s disease who underwent laparoscopic right liver resection for hepatocellular carcinoma.

Satisfactory intra and postoperative analgesia was achieved by a combined continuous ESP block, transversus abdominis plane (TAP), and oblique subcostal TAP blocks.

Surgery and postoperative period was uneventful. No opioids were administered during hospitalization.

A combined of thoracic and abdominal wall blocks can be an effective approach for intra and postoperative analgesia in highrisk patients undergoing laparoscopic liver resection.

Further clinical research is recommended to establish the effectiveness of the ESP block as an analgesic technique in this surgery.

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How to Cite
Piangatelli, C., Dalla Bona, E., Tavoletti, D., Rosanò, E., Mocchegiani, F., Vivarelli, M., & Cerutti, E. (2020). Continuous erector spinae plane block for pain management in laparoscopic liver resection: case report. Colombian Journal of Anesthesiology, 48(3), 164-168. Retrieved from https://www.revcolanest.com.co/index.php/rca/article/view/909

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Published
2020-07-01
How to Cite
Piangatelli, C., Dalla Bona, E., Tavoletti, D., Rosanò, E., Mocchegiani, F., Vivarelli, M., & Cerutti, E. (2020). Continuous erector spinae plane block for pain management in laparoscopic liver resection: case report. Colombian Journal of Anesthesiology, 48(3), 164-168. Retrieved from https://www.revcolanest.com.co/index.php/rca/article/view/909
Section
Case Report / Case Series