Ultrasound-Guided Erector Spinae Plane Block for Perioperative Analgesia in Cervical and Thoracic Spine Surgeries - A Case Series.

Erector spinae plane (ESP) block is a recently introduced regional technique for pain management. However, its usefulness for perioperative analgesia in cervical and thoracic spine surgeries is underutilized. In this case series, we reviewed the case records of seven patients who received ultrasound-guided ESP block for perioperative analgesia for cervical and thoracic spine surgeries during a two-month period. We evaluated the performance of the ESP block with regards to intraoperative nociception and hemodynamics, postoperative pain, and need of rescue analgesia in these patients. The median age of our patients was 28 years (range 5-74 years) and the duration of surgery was 300 minutes (range 240-540 minutes). The surgical pleth index, a marker of intraoperative nociception, was below the threshold of 50 at most time-points during the surgery. Similarly, intraoperative hemodynamic parameters (HR and BP) were stable throughout the surgery. Postoperative pain control was good during the initial 48 after surgery with median NRS score of 2 at rest and 4 with movement. The ESP block results in good intraoperative and postoperative analgesia and also provides hemodynamic stability and opioid-sparing effect for cervical and thoracic spine surgeries.