Slama Richard, Lerner Julia, Kyle Adrianna
Emergency Medicine, Riverside Regional Medical Center, Newport News, USA.
Cureus. 2024 Aug 20;16(8):e67327. doi: 10.7759/cureus.67327. eCollection 2024 Aug.
Ultrasound-guided erector spinae plane block (ESPB) has emerged as a valuable technique in pain management. Though frequently used in chronic and postoperative pain, it remains underutilized in the emergency department (ED) setting. In particular, this block has become attractive because it is rapid, safe, and efficacious for a variety of different pain syndromes that are commonly encountered in the emergency department setting. Of particular importance is that this block results in pure sensory blockade, allowing patient movement after the procedure has been performed. This case series explores the efficacy of the ESPB in various clinical scenarios, including refractory cervical radiculopathy, rib fractures, obstructive nephrolithiasis, and sciatica. Each of these patients presented with symptoms of refractory aggressive pain management strategies, including non-steroidal anti-inflammatory drugs (NSAIDS), acetaminophen, narcotics, muscle relaxers, and ketamine. After undergoing ESPB, the patients were able to be successfully discharged without return visits to the emergency department for the return of their pain. This case series aims to show the utility of this procedure for refractory painful conditions and also reviews other indications where the block may be used. While previous reports have shown the utility of this block at individual levels, we present the flexibility of this block being used at multiple levels of the spine.
超声引导下竖脊肌平面阻滞（ESPB）已成为疼痛管理中的一项重要技术。尽管它常用于慢性疼痛和术后疼痛，但在急诊科（ED）环境中仍未得到充分利用。特别是，这种阻滞因其对急诊科常见的各种不同疼痛综合征快速、安全且有效而备受关注。尤为重要的是，这种阻滞可产生单纯的感觉阻滞，使患者在操作后仍能活动。本病例系列探讨了ESPB在各种临床场景中的疗效，包括难治性颈神经根病、肋骨骨折、梗阻性肾结石和坐骨神经痛。这些患者均采用了包括非甾体类抗炎药（NSAIDs）、对乙酰氨基酚、麻醉药、肌肉松弛剂和氯胺酮在内的难治性积极疼痛管理策略。接受ESPB治疗后，患者均成功出院，未因疼痛复发而再次就诊于急诊科。本病例系列旨在展示该操作对难治性疼痛状况的实用性，并回顾该阻滞可能适用的其他适应症。虽然先前的报告已在个体层面展示了该阻滞的实用性，但我们展示了该阻滞在脊柱多个节段使用的灵活性。
