Erector spinae plane block for the management of chronic shoulder pain: a case report

Mauricio Forero, Manikandan Rajarathinam, Sanjib Das Adhikary, Ki Jinn Chin
Canadian Journal of Anaesthesia 2018, 65 (3): 288-293

PURPOSE: The erector spinae plane (ESP) block has been described in the successful management of both thoracic and abdominal pain. Since the erector spinae muscle extends to the cervical spine, the ESP block may be potentially useful in painful conditions of the shoulder girdle.

CLINICAL FEATURES: We performed a series of ESP blocks at the T2/T3 level in an elderly male patient with chronic shoulder pain. Immediate and profound analgesia with improved range of motion was consistently observed following the block. There was detectable sensory block in the congruent cervico-thoracic dermatomes with no motor block. Computed tomography imaging showed the spread of radiocontrast up to the C3 level in the vicinity of the neural foramina. Clinical analgesia generally outlasted the expected duration of conduction blockade and significantly contributed to overall improvement in the patient's symptoms.

CONCLUSIONS: The ESP block may be a promising alternative to other interventional procedures in the management of chronic shoulder pain and deserves further study.

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