Dual erector spinae plane block for complex traumas of upper and lower limb: an opioid reduction strategy—a case series

Abstract

BackgroundPatients with polytrauma (fractures of the humerus and the femur) require concurrent operative fixation. Pain originating from multiple operative sites leads to increasing doses of opioid-based analgesia, which has detrimental effects in the form of longer hospital stays, higher costs, and increased mortality.Case presentationIn twelve patients with humerus and femur fractures, a cervical erector spinae plane block (ESPB) at the level of T1 and a lumbar ESPB at the level of L2 were administered with a catheter and continuous infusion technique for postoperative analgesia. None of these patients required opioids in the postoperative period. The catheters were removed after 48 h.ConclusionsA dual ESPB can be used successfully in patients with multiple injuries by appropriately selecting the level of intervention, and opioid-sparing analgesia can be effectively delivered to these patients.