Erector Spinae Plane Block for Open and Laparoscopic Liver Surgery: Two Case Reports

摘要

Epidural analgesia has long been regarded as the gold standard in abdominal surgery. However, concerns regarding risks associated with central neuraxial blockade, catheter placement and the presence of coagulopathy in patients undergoing liver resection have limited its use. Bilateral erector spinae plane blocks and catheter placement may mimic the effects of epidural analgesia by blocking both somatic and visceral pain while concomitantly avoiding central neuraxial blockade and catheter placement. We describe our experience in using the erector spinae plane block and catheter placement as part of a multimodal analgesia approach in a patient undergoing laparoscopic and another patient undergoing open liver resection. Our findings concur with previous reports which suggest that erector spinae plane blocks may be more efficacious as somatic rather than visceral analgesia. However, we conclude that further studies on factors affecting its efficacy should be conducted in view of the present lack of researched evidence.