Ultrasound guided erector spinae plane catheter for thoracotomy: a case report

Major thoracic surgery results in severe postoperative pain. Epidural analgesia is considered the gold standard for pain management after thoracic surgery. However, epidural blocks are contraindicated in certain clinical conditions. Pain management in such patients poses a unique challenge to the anesthesiologists. Erector spinae plane block (ESPB) is a less invasive and relatively new technique, which has shown promising results. This case report describes the use of ESPB as an alternate analgesic technique. A 65-year-old man underwent thoracotomy and left upper lobe resection. Intraoperative and postoperative pain was managed with intermittent boluses of bupivacaine through the erector spinae plane catheter. Effective analgesia was achieved with minimal morphine consumption in postoperative period. Although central neuraxial blocks are considered to be gold standard for major thoracic surgery but where applicable, alternatives can be opted for better patient outcomes.