Cervical erector spinae plane block catheter for shoulder disarticulation surgery

  • Hassan Hamadnalla
  • Hesham Elsharkawy
  • Tetsuya Shimada
  • Kamal Maheshwari
  • Wael Ali Sakr Esa
  • Ban C. H. TsuiEmail author

To the Editor,

For shoulder disarticulation surgery, a continuous brachial plexus (BP) block is suboptimal because of close proximity to the surgical field and inadequate anesthetic coverage for thoracic dermatomes. Recently, a novel description was published outlining the use of a T2–3 erector spinae plane (ESP) catheter advanced into a cervical location from the thoracic level to serve as an alternative to a BP block for complex upper extremity procedures.1 Instead of facing potential challenges from threading an ESP catheter from the thoracic region, we report (with patient consent) a similar case of a patient undergoing a unilateral shoulder disarticulation but with an ESP catheterization at the C7 level.

A 62-yr-old, 82-kg male with left lower lobe stage IV lung carcinoma presented with intractable pain due to a pathologic fracture of the left distal humerus. His baseline analgesics included methadone 15 mg and gabapentin 60 mg every 12 hr, with additional oxycodone 10–20 mg every...


Conflicts of interest

None declared.

Editorial responsibility

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


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Copyright information

© Canadian Anesthesiologists' Society 2019

Authors and Affiliations

  1. 1.Department of Outcomes Research, Anesthesiology InstituteCleveland ClinicClevelandUSA
  2. 2.Department of General Anesthesiology, Anesthesiology InstituteCleveland ClinicClevelandUSA
  3. 3.Department of AnesthesiologyNational Defense Medical CollegeSaitamaJapan
  4. 4.Department of AnesthesiologyStanford UniversityStanfordUSA

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