Abstract
BackgroundUltrasound-guided erector spine plane (ESP) block is widely used in perioperative analgesia for back, chest and abdominal surgery. The extent and distribution of this block remain controversial. This study was performed to assess the analgesia range of an ultrasound-guided ESP block.MethodsThis prospective observational volunteer study consisted of 12 healthy volunteers. All volunteers received an erector spinae plane block at the left T5 transverse process using real-time ultrasound guidance. Measured the cutaneous sensory loss area (CSLA) and cutaneous sensory declination area (CSDA) using cold stimulation at different time points after blockade until its disappearance. The CSLA and CSDA were mapped and then calculated. The block range was described by spinous process level and lateral extension. The effective block duration for each volunteer was determined and recorded.ResultsThe cold sensory loss concentrates at T6-T9. The decline concentrates primarily at T4-T11. The lateral diffusion of block to the left side did not cross the posterior axillary line, and reached the posterior median line on the right. The area of cutaneous sensory loss was (172 ± 57) cm2, and the area of cutaneous sensory decline was (414 ± 143) cm2. The duration of cutaneous sensory decline was (586 ± 28) minutes.ConclusionUltrasound-guided erector spine plane block with 20 mL of 0. 5% ropivacaine provided a widespread cutaneous sensory block in the posterior thorax, but did not reach the anterior chest, lateral chest, or abdominal walls. The range of the blockade suggested that the dorsal branch of spinal nerve was blocked.Trial registrationChinese Clinical Trial Registry, CHiCTR1800014438. Registered 13 January 2018
Highlights
Ultrasound-guided erector spine plane (ESP) block is widely used in perioperative analgesia for back, chest and abdominal surgery
The range of the blockade suggested that the dorsal branch of spinal nerve was blocked
Volunteers required an American society of anesthesiologists (ASA) physical classification system status of I-II, a Body mass index (BMI) of 18.5–28.0 kg/m2, the area of study for cutaneous sensation needed to be intact in order to be confirmed by the cold stimulation test
Summary
This prospective observational volunteer study consisted of 12 healthy volunteers. All volunteers received an erector spinae plane block at the left T5 transverse process using real-time ultrasound guidance. Measured the cutaneous sensory loss area (CSLA) and cutaneous sensory declination area (CSDA) using cold stimulation at different time points after blockade until its disappearance. The effective block duration for each volunteer was determined and recorded. Volunteers This observational volunteer study was approved by the University’s Institutional Review Board (IRB No.2017–22) and written informed consent was obtained from all subjects participating in the trial. All 12 volunteers that were enrolled provided written informed consent. Volunteers required an American society of anesthesiologists (ASA) physical classification system status of I-II, a Body mass index (BMI) of 18.5–28.0 kg/m2, the area of study for cutaneous sensation needed to be intact in order to be confirmed by the cold stimulation test. Exclusion criteria were as follows: allergy to Ropivacaine or other drugs used in this trial, and inability to communicate, ASA grade ≥ 3, BMI less than 18.5 kg/m2 or greater than 28 kg/m2, abnormal platelet function or other coagulopathy, infectious disease of the skin sensation, abnormal skin sensation, spinal deformity, neuropathy, spinal cord disease, torso scar in area studied, and/or a history of abdominal surgery
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