TITLE:
Erector Spinae Plane Block for Mastectomy and Breast Flap Reconstructive Surgery: A Three Case Series
AUTHORS:
Wei Shyan Siow, Jimmy Guan Cheng Lim, Kwee Lian Woon
KEYWORDS:
Erector Spinae Block, Analgesia, Mastectomy, Breast Reconstructive Surgery, Flap
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.10 No.1,
January
16,
2020
ABSTRACT: Uncontrolled pain after breast surgery can have early to chronic repercussions. The repertoire of pre-emptive opioid-sparing analgesic options includes regional blocks such as paravertebral blocks to myofascial blocks and more recently the Erector Spinae (ESP) block. Case 1 demonstrates the ESP block as an easy and conveniently performed post-operative rescue block for a patient who still experienced uncontrolled pain despite a combination of myofascial blocks and systemic analgesics. Case 2 and 3 demonstrate the advantage of providing an extensive coverage of surgical field in breast reconstruction surgery covering variable donor sites. It was due to the extent of coverage, that allowed the placement of ESP block catheter distantly without interrupting the surgical site. Post operative prolongation of pain relief was also successful by titrating analgesia via intermittent boluses. In our case series, the ESP block consistently and safely provided satisfactory pain relief for breast reconstruction surgery. It can be a viable option for peri-operative analgesia compared to other more invasive or less extensive alternatives.