Mechanism of the erector spinae plane block: insights from a magnetic resonance imaging study
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To the Editor,
The erector spinae plane block (ESPB) has emerged as a valuable regional anesthesia technique for a range of thoracic, abdominal, and other procedures. Early cadaveric injection and computerized tomographic scan imaging studies1,2 have suggested that the local anesthetic spreads in a cephalocaudal direction within the fascial plane, deep to the erector spinae muscle in the paraspinal region and potentially spreads towards the paravertebral space through the inter-transverse soft tissue.3 How the anesthetic spreads to achieve somatic and visceral blockade is largely unclear.
We present magnetic resonance imaging (MRI) that provides additional anatomical information on the potential mechanism of the ESPB. A 38-yr-old female (who consented to this report) with post-surgical chronic visceral abdominal pain received an ultrasound-guided ESPB, which rendered her pain free. Four months later, the patient was still pain free but gave written consent to have an investigative...
Conflicts of interest
This submission was handled by Dr. Hilary P. Grocott, Editor-in-Chief, Canadian Journal of Anesthesia.