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Case Reports
. 2020 Aug;48(4):331-333.
doi: 10.5152/TJAR.2019.55047. Epub 2019 Nov 18.

Erector Spinae Plane Block for Proximal Shoulder Surgery: A Phrenic Nerve Sparing Block!

Sandeep Diwan  1 , Abhijit Nair  2
Affiliations
Case Reports

Erector Spinae Plane Block for Proximal Shoulder Surgery: A Phrenic Nerve Sparing Block!

Sandeep Diwan et al. Turk J Anaesthesiol Reanim. 2020 Aug.

Abstract

There are several indications of erector spinae plane block (ESPB) for managing postoperative surgical pain. We investigated the efficacy of ultrasound-guided ESPB at T2-T3 level in five patients undergoing surgery for proximal humerus fracture and found that it provided excellent analgesia in the postoperative period. To investigate the spread of local anaesthetic at this level, we performed contrast-enhanced computed tomography studies, to understand the possible mechanism of action. We believe that ESPB at this level is a good and safe alternative to routinely used brachial plexus blocks, as it not only provides good analgesia but also spares the phrenic nerve.

Keywords: Erector spinae; shoulder; surgery; ultrasound.

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Conflict of interest statement

Conflict of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Axial section at C 5–6 level SCM: sternocleidomastoid muscle; Le Sc: levator scapulae muscle; Sp Ca: splenius capitis muscle; VB: vertebral body; TZ: trapezius muscle
Figure 2
Figure 2
Sagittal section: Contrast extending from C2–T8 above ESM and at one point at T4 below ESM ESM: erector spinae muscle; TZ: trapezius muscle
Figure 3
Figure 3
Coronal section: The contrast spread across the erector spinae plane; cephalad and caudad spreads laterally ES: erector spinae muscle; TZ: trapezius muscle
See this image and copyright information in PMC

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