ERECTOR SPINAE PLANE BLOCK FOR POSTOPERATIVE ANALGESIA FOR LAPAROSCOPIC UPPER ABDOMINAL SURGERY: A CASE REPORT

L. Valente¹, S. Mattacchione², P. Nika¹, A. De Gregorio², G. Mezzetti², N. Lomartire¹ | ¹Dept. of Anesthesia and Resuscitation, UOC ,"SS.ma Trinità Hospital, Sora; ²Dept. of General Surgery, UOC, "SS.ma Trinità" Hospital, Sora

The Erector Spinae Plane Block (ESP) is a novel regional technique for anesthesia or analgesia, obtained with an infusion of local anesthetic between transverse process and the erector spinae muscles. The literature shows the efficacy of ESP block as a postoperative analgesic method for laparoscopic abdominal surgery. We report the case of a 62-year-old male patient scheduled for laparoscopic cholecystectomy and type III hiatal hernia repair. We performed a bilateral ultrasound-guided ESP block at T5-T6 level before general anesthesia induction: the patient was aweke in sitting position, with continuous vital parameter monitoring. To administrate the block we used Ropivacaine 0,375% 20 ml on each side, followed by intravenous infusion of dexamethasone 4mg as an adjuvant. Soon after the block, general anesthesia was induced and the procedure was started. The procedure was performed without adverse event. After surgery, in recovery room the patient reported a very good analgesia (NRS pain score 0 upon awaking). We prescribed Paracetamol 1 gr IV every 8 hours and “on demand” FANS in case of pain; in the first 24 hours after surgery only one rescue dose was administrated. No nausea or vomiting was reported. The patient was mobilized easily and was discharged in second day after surgery. The ESP block, with ultrasound guidance ia a simple and safe technique that can reduce IV use of pain medications after abdominal surgery and also reduce intraoperative opioid use. Furthermore can increase patients satisfaction and contribute to fast recovery after surgery.