Ultrasound guided unilateral erector spinae blockade in open cholecystectomy in COVID-19 era

ABSTRACT

Background: The erector spinae plane (ESP) blockade acts as a potent unilateral analgesic technique. The block is performed by injecting local anaesthetic drug in the plane between the erector spinae muscle and the vertebral transverse process, with its effect due to diffusion of the local anaesthetic into the paravertebral space through spaces between the adjacent vertebrae. It is a relatively safe and easy technique as compared to the thoracic epidural because our target in ESP blockade is the transverse process, which is identified easily and is distant from neural or major vascular structures and the pleura. Aim of the study To assess the analgesic effect of ultrasound guided unilateral erector spinae blockade in open cholecystectomy Material and methods:We present a case series of ESP blockade under ultrasound guidance in nine patients scheduled for open cholecystectomy because surgeons chose to avoid laparoscopic surgery due to the increased risk of COVID-19 infection due to intraperitoneal aerosol generation. Results: All patients with postoperative ESP blockade maintained an NRS pain score of 03/10 for 24 h, except for those requiring emergency analgesia. The pain relief was excellent in all our patients and there were no complaints of nausea, vomiting. Conclusion: ESP blockade is proving to be a successful technique for intraoperative and postoperative analgesia.