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Cervical erector spinae plane block catheter using a thoracic approach: an alternative to brachial plexus blockade for forequarter amputation

  • Ban C. H. TsuiEmail author
  • David Mohler
  • Thomas J. Caruso
  • Jean Louis Horn
Correspondence

To the Editor,

We read with interest the recent report outlining the utilization of an erector spinae plane block (ESPB) for chronic shoulder pain.1 The reporting of clinical outcomes and the identification of contrast spread to the cervical spine nerve roots with an ESPB inspired us to use one in managing a patient who required analgesia of the brachial plexus and anterior thoracic distribution.

An 81-yr-old female (consenting to this report) with congestive heart failure and a history of breast cancer presented with a painful recurrent radiation-induced sarcoma of the left proximal humerus. The patient initially decided to forego further treatment because of anticipated debilitating pain and instead to seek an end-of-life care. After discussion with the surgical team, the patient elected to undergo forequarter amputation intended to optimize palliative pain control, but also had a reasonable possibility for a cure. In the preoperative area, we placed a left ultrasound-guided ESPB...

Notes

Conflicts of interest

None declared.

Editorial responsibility

This submission was handled by Dr. Hilary P. Grocott, Editor-in-Chief, Canadian Journal of Anesthesia.

References

  1. 1.
    Forero M, Rajarathinam M, Adhikary SD, Chin KJ. Erector spinae plane block for the management of chronic shoulder pain: a case report. Can J Anesth 2018; 65: 288-93.CrossRefGoogle Scholar
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    Kashani HH, Grocott HP. Clarity needed as to the optimal dose and volume of local anesthetic for erector spinae plane blockade for posterior rib fractures. Am J Emerg Med 2018. DOI:  https://doi.org/10.1016/j.ajem.2018.03.032.Google Scholar

Copyright information

© Canadian Anesthesiologists' Society 2018

Authors and Affiliations

  1. 1.Department of Anesthesiology, Perioperative, and Pain MedicineStanford UniversityPalo AltoUSA
  2. 2.Department of Orthopedic SurgeryStanford UniversityPalo AltoUSA

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