Blockade of surrounding spinal dorsal rami, lateral cutaneous branches of intercostal nerves, and usually spinal ventral rami near injection site
Blockade of somatic dermatomes of anterior and posterior chest and abdominal wall
Ventral rami spread results in visceral analgesia clinically observed
Injection at lumbar levels result in analgesia of iliac crest, hip, and lower extremity
Single-shot results in analgesia for 4-6 hours
Catheter can provide analgesia for > 6 hours
Can be performed with ultrasound or CT imaging modalities
PREPROCEDURE
Indications
Contraindications
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things to Do
Things to Avoid
OUTCOMES
Problems
Complications
Selected References
Adhikary SD et al: The effect of erector spinae plane block on respiratory and analgesic outcomes in multiple rib fractures: a retrospective cohort study. Anaesthesia. 74(5):585-93, 2019
Baca Q et al: Erector spinae plane block for pediatric palliative care. Paediatr Anaesth. 29(4):386-7, 2019
Balaban O et al: Lumbar erector spinae plane catheterization for continuous postoperative analgesia in total knee arthroplasty: a case report. J Clin Anesth. 55:138-9, 2019
De Cassai A et al: Old approach for a new indication: shamrock sign for ESP block. Reg Anesth Pain Med. ePub, 2019
Gürkan Y et al: Iliac crest bone graft donor site analgesia: a new indication for erector spinae plane block. Can J Anaesth. 66(3):338-9, 2019
Hamilton DL: Reducing the risk of pneumothorax following erector spinae plane block. J Clin Anesth. 56:3, 2019
Noss C et al: Erector spinae plane block for open-heart surgery: a potential tool for improved analgesia. J Cardiothorac Vasc Anesth. 33(2):376-7, 2019
Santonastaso DP et al: Ultrasound guided erector spinae plane block for open partial nephrectomy: only an alternative? J Clin Anesth. 56:55-6, 2019
Tsui BCH et al: The erector spinae plane (ESP) block: a pooled review of 242 cases. J Clin Anesth. 53:29-34, 2019
Tulgar S et al: Ultrasound guided erector spinae plane block relieves lower cervical and interscapular myofascial pain, a new indication. J Clin Anesth. 53:74, 2019
Xu JL et al: Ultrasound-guided erector spinae plane block using long-range multi-orifice catheter for chest wall pain management in patients with multiple rib fractures. Am Surg. 85(1):e6-e8, 2019
Ahiskalioglu A et al: (MS 19311) Ultrasound guided erector spinae plane block as a safe and effective method to treat herpes zoster pain. Am J Emerg Med. 37(6):1192-4, 2018
Alici HA et al: High volume single injection lumbar erector spinae plane block provides effective analgesia for lower extremity herpes zoster. J Clin Anesth. 54:136-7, 2018
De la Cuadra-Fontaine JC et al: Continuous erector spinae plane block for thoracic surgery in a pediatric patient. Paediatr Anaesth. 28(1):74-5, 2018
Finneran JJ 4th et al: Erector spinae plane blocks provide analgesia for breast and axillary surgery: a series of 3 cases. Reg Anesth Pain Med. 43(1):101-2, 2018
Hacibeyoglu G et al: USG guided bilateral erector spinae plane block is an effective and safe postoperative analgesia method for living donor liver transplantation. J Clin Anesth. 49:36-7, 2018
Ince I et al: Ultrasound-guided erector spinae plane block for acute herpes zoster pain management: is it safe? Am J Emerg Med. 37(6):1192, 2018
Ince I et al: Erector spinae plane block catheter insertion under ultrasound guidance for thoracic surgery: case series of three patients. Eurasian J Med. 50(3):204-6, 2018
Ivanusic J et al: A cadaveric study investigating the mechanism of action of erector spinae blockade. Reg Anesth Pain Med. 43(6):567-71, 2018
Kadam VR et al: Use of erector spinae plane block in open abdominal surgery and cancer pain. J Anaesthesiol Clin Pharmacol. 34(4):564-7, 2018
Kim E et al: The erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy. Chin Med J (Engl). 131(15):1877-8, 2018
Kose HC et al: Lumbar versus thoracic erector spinae plane block: similar nomenclature, different mechanism of action. J Clin Anesth. 48:1, 2018
Luftig J et al: Successful emergency pain control for posterior rib fractures with ultrasound-guided erector spinae plane block. Am J Emerg Med. 36(8):1391-6, 2018
Macaire P et al: Ultrasound-guided continuous thoracic erector spinae plane block within an enhanced recovery program is associated with decreased opioid consumption and improved patient postoperative rehabilitation after open cardiac surgery-a patient-matched, controlled before-and-after study. J Cardiothorac Vasc Anesth. 33(6):1659-67, 2018
Melvin JP et al: Low thoracic erector spinae plane block for perioperative analgesia in lumbosacral spine surgery: a case series. Can J Anaesth. 65(9):1057-65, 2018
Vidal E et al: Erector spinae plane block: a cadaver study to determine its mechanism of action. Rev Esp Anestesiol Reanim. 65(9):514-9, 2018
Forero M et al: The erector spinae plane block: a novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med. 41(5):621-7, 2016
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Synonyms
Erector spinae plane block (ESPB)
Definitions
Blockade of surrounding spinal dorsal rami, lateral cutaneous branches of intercostal nerves, and usually spinal ventral rami near injection site
Blockade of somatic dermatomes of anterior and posterior chest and abdominal wall
Ventral rami spread results in visceral analgesia clinically observed
Injection at lumbar levels result in analgesia of iliac crest, hip, and lower extremity
Single-shot results in analgesia for 4-6 hours
Catheter can provide analgesia for > 6 hours
Can be performed with ultrasound or CT imaging modalities
PREPROCEDURE
Indications
Contraindications
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Expected Outcome
Things to Do
Things to Avoid
OUTCOMES
Problems
Complications
Selected References
Adhikary SD et al: The effect of erector spinae plane block on respiratory and analgesic outcomes in multiple rib fractures: a retrospective cohort study. Anaesthesia. 74(5):585-93, 2019
Baca Q et al: Erector spinae plane block for pediatric palliative care. Paediatr Anaesth. 29(4):386-7, 2019
Balaban O et al: Lumbar erector spinae plane catheterization for continuous postoperative analgesia in total knee arthroplasty: a case report. J Clin Anesth. 55:138-9, 2019
De Cassai A et al: Old approach for a new indication: shamrock sign for ESP block. Reg Anesth Pain Med. ePub, 2019
Gürkan Y et al: Iliac crest bone graft donor site analgesia: a new indication for erector spinae plane block. Can J Anaesth. 66(3):338-9, 2019
Hamilton DL: Reducing the risk of pneumothorax following erector spinae plane block. J Clin Anesth. 56:3, 2019
Noss C et al: Erector spinae plane block for open-heart surgery: a potential tool for improved analgesia. J Cardiothorac Vasc Anesth. 33(2):376-7, 2019
Santonastaso DP et al: Ultrasound guided erector spinae plane block for open partial nephrectomy: only an alternative? J Clin Anesth. 56:55-6, 2019
Tsui BCH et al: The erector spinae plane (ESP) block: a pooled review of 242 cases. J Clin Anesth. 53:29-34, 2019
Tulgar S et al: Ultrasound guided erector spinae plane block relieves lower cervical and interscapular myofascial pain, a new indication. J Clin Anesth. 53:74, 2019
Xu JL et al: Ultrasound-guided erector spinae plane block using long-range multi-orifice catheter for chest wall pain management in patients with multiple rib fractures. Am Surg. 85(1):e6-e8, 2019
Ahiskalioglu A et al: (MS 19311) Ultrasound guided erector spinae plane block as a safe and effective method to treat herpes zoster pain. Am J Emerg Med. 37(6):1192-4, 2018
Alici HA et al: High volume single injection lumbar erector spinae plane block provides effective analgesia for lower extremity herpes zoster. J Clin Anesth. 54:136-7, 2018
De la Cuadra-Fontaine JC et al: Continuous erector spinae plane block for thoracic surgery in a pediatric patient. Paediatr Anaesth. 28(1):74-5, 2018
Finneran JJ 4th et al: Erector spinae plane blocks provide analgesia for breast and axillary surgery: a series of 3 cases. Reg Anesth Pain Med. 43(1):101-2, 2018
Hacibeyoglu G et al: USG guided bilateral erector spinae plane block is an effective and safe postoperative analgesia method for living donor liver transplantation. J Clin Anesth. 49:36-7, 2018
Ince I et al: Ultrasound-guided erector spinae plane block for acute herpes zoster pain management: is it safe? Am J Emerg Med. 37(6):1192, 2018
Ince I et al: Erector spinae plane block catheter insertion under ultrasound guidance for thoracic surgery: case series of three patients. Eurasian J Med. 50(3):204-6, 2018
Ivanusic J et al: A cadaveric study investigating the mechanism of action of erector spinae blockade. Reg Anesth Pain Med. 43(6):567-71, 2018
Kadam VR et al: Use of erector spinae plane block in open abdominal surgery and cancer pain. J Anaesthesiol Clin Pharmacol. 34(4):564-7, 2018
Kim E et al: The erector spinae plane block for postoperative analgesia after percutaneous nephrolithotomy. Chin Med J (Engl). 131(15):1877-8, 2018
Kose HC et al: Lumbar versus thoracic erector spinae plane block: similar nomenclature, different mechanism of action. J Clin Anesth. 48:1, 2018
Luftig J et al: Successful emergency pain control for posterior rib fractures with ultrasound-guided erector spinae plane block. Am J Emerg Med. 36(8):1391-6, 2018
Macaire P et al: Ultrasound-guided continuous thoracic erector spinae plane block within an enhanced recovery program is associated with decreased opioid consumption and improved patient postoperative rehabilitation after open cardiac surgery-a patient-matched, controlled before-and-after study. J Cardiothorac Vasc Anesth. 33(6):1659-67, 2018
Melvin JP et al: Low thoracic erector spinae plane block for perioperative analgesia in lumbosacral spine surgery: a case series. Can J Anaesth. 65(9):1057-65, 2018
Vidal E et al: Erector spinae plane block: a cadaver study to determine its mechanism of action. Rev Esp Anestesiol Reanim. 65(9):514-9, 2018
Forero M et al: The erector spinae plane block: a novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med. 41(5):621-7, 2016
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