Cervical erector spinae plane block catheter using a thoracic approach: an alternative to brachial plexus blockade for forequarter amputation
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To the Editor,
We read with interest the recent report outlining the utilization of an erector spinae plane block (ESPB) for chronic shoulder pain.1 The reporting of clinical outcomes and the identification of contrast spread to the cervical spine nerve roots with an ESPB inspired us to use one in managing a patient who required analgesia of the brachial plexus and anterior thoracic distribution.
An 81-yr-old female (consenting to this report) with congestive heart failure and a history of breast cancer presented with a painful recurrent radiation-induced sarcoma of the left proximal humerus. The patient initially decided to forego further treatment because of anticipated debilitating pain and instead to seek an end-of-life care. After discussion with the surgical team, the patient elected to undergo forequarter amputation intended to optimize palliative pain control, but also had a reasonable possibility for a cure. In the preoperative area, we placed a left ultrasound-guided ESPB...
Conflicts of interest
This submission was handled by Dr. Hilary P. Grocott, Editor-in-Chief, Canadian Journal of Anesthesia.
- 3.Wilkie DJ, Ezenwa MO. Pain and symptom management in palliative care and at end of life. 2012; 60: 357-64.Google Scholar