A clinical case of the use of an extended ESP block during simultaneous surgery in plastic surgery
https://doi.org/10.24884/2078-5658-2025-22-4-102-107
Abstract
Aesthetic plastic surgery is an actively developing branch of medicine, in which operations are accompanied by a pain syndrome that requires, in accordance with modern concepts, a multimodal approach to anesthesia. An important role in the multimodal approach is played by regional, ULTRASOUND-associated anesthesia methods, which contribute not only to reducing intraoperative opioid load, but also to reducing pain in the postoperative period. This article describes a clinical case of the use of a TAP block and an extended ESP block in a patient with remission of opioid dependence who underwent simultaneous surgical intervention in the form of abdominoplasty, breast tightening and enlargement. Narcotic analgesics were not used during anesthesia, as well as throughout the entire postoperative period. The use of the ESP block helps to reduce pain in the intraoperative and postoperative period.
About the Authors
D. S. Smolyaninova
Dr. Albrecht Center for Beauty and Women’s Health
Russian Federation
Russian Federation
Smolyaninova Darya S., Cand. of Sci. (Med.), Head of the Department of Anesthesiol ogy and Intensive Care, Anesthesiologist and Intensivist, Dr. Albrecht Center for Beauty and Women’s Health, Lec turer at the Department of Anesthesiology and Intensive Care, Voronezh State Medical University named after N.N. Burdenko
87, Proletarskaya str., Voronezh, 394036
D. V. Vorobyov
Dr. Albrecht Center for Beauty and Women’s Health
Russian Federation
Russian Federation
Vorobyov Dmitry V., Deputy Chief Physician for Medical Affairs, Anesthesiologist and Intensivist
87, Proletarskaya str., Voronezh, 394036
M. V. Zimin
Dr. Albrecht Center for Beauty and Women’s Health
Russian Federation
Russian Federation
Zimin Maxim V., Anesthesiologist and Intensivist
87, Proletarskaya str., Voronezh, 394036
S. V. Matsaev
Dr. Albrecht Center for Beauty and Women’s Health
Russian Federation
Russian Federation
Matsaev Sergey V., Plastic Surgeon, Director
87, Proletarskaya str., Voronezh, 394036
References
1. Koryachkin V. A. Peripheral nerve blockages and ultrasound navigation. Regional anesthesia and treatment of acute pain, 2020, vol. 14, no. 1, p. 4–5. (In Russ.). https://doi.org/10.17816/1993-6508-2020-14-1-4-5.
2. Morunova A. Y., Yezhevskaya A. A., Prusakova Zh. B. et al. Comparative ef fectiveness of ESP block and epidural analgesia in spinal surgery: a prospective randomized trial. Anesthesiology and Intensive Care, 2024, no. 5, pp. 72–81. (In Russ.). https://doi.org/10.17116/anaesthesiology202405172.
3. Shatalov V. I., Belolipetsky S. S., Strogonov A. I. et al. Evaluation of the effectiveness of the erector spinae plane (ESP) block in endovideosurgical hernioplasty of inguinal hernias. Messenger of Anesthesiology and Intensive Care, 2023, vol. 20, no. 1, pp. 24–35. (In Russ.).
4. Aksu C., Kuş A., Yörükoğlu H. U. et al. Analgesic effect of the bi-level injection erector spinae plane block after breast surgery: a randomized controlled trial // The Journal of The Turkish Society of Algology. – 2019. – Vol. 31. – P. 132–137. https://doi.org/10.14744/agri.2019.61687.
5. Altınsoy S., Özkan D., Akelma F. K. et al. Analgesic efficacy of ultra sound guided unilateral erector spinae plane block for laparoscopic in guinal hernia repair: a randomized controlled study // Turkish Journal of Medical Sciences. – 2022. – Vol. 52, № 3. – P. 631–640. https://doi.org/10.55730/1300-0144.5355.
6. Altıparmak B., Korkmaz Toker M., Uysal A. İ. et al. Comparison of the ef fects of modified pectoral nerve block and erector spinae plane block on postoperative opioid consumption and pain scores of patients after radical mastectomy surgery: A prospective, randomized, controlled trial // Jour nal of Clinical Anesthesia. – 2019. – Vol. 54, № 3. – P. 61–65. https://doi.org/10.1016/j.jclinane.2018.10.040.
7. Chin K. J., El-Boghdadly K. Mechanisms of action of the erector spinae plane (ESP) block: a narrative review // Annals of Anesthesiology. – 2021. – Vol. 68, № 3. – P. 387–408. https://doi.org/10.1007/s12630-020-01875-2.
8. Chin K. J., Malhas L., Perlas A. The erector spinae plane block provides vis ceral abdominal analgesia in bariatric surgery: a report of 3 cases // Regional Anesthesia and Pain Medicine. – 2017. – Vol. 42, № 3. – P. 372–376. https://doi.org/10.1097/AAP.0000000000000581.
9. De Cassai A., Bonvicini D., Correale C. et al. Erector spinae plane block: a systematic qualitative review // Minerva Anestesiologica. – 2019. – Vol. 85, № 3. – P. 308–319. https://doi.org/10.23736/S0375-9393.18.13341-4.
10. Diwan S., Nair A. Is paravertebral-epidural spread the underlying mecha nism of action of erector spinae plane block // Turkish Journal of Anaes thesiology and Reanimation. – 2020. – Vol. 48, № 1. – P. 86–87. https://doi.org/10.5152/TJAR.2019.81226.
11. Finnerty D. T., Buggy D. J. Efficacy of the erector spinae plane (ESP) block for quality of recovery in posterior thoraco-lumbar spinal decompression surgery: study protocol for a randomised controlled trial // Trials. – 2021. – P. 150. https://doi.org/10.1186/s13063-021-05101-2.
12. Gürkan Y., Aksu C., Kuş A. et al. Erector spinae plane block and thoracic para vertebral block for breast surgery compared to IV-morphine: A randomized controlled trial // Journal of Clinical Anesthesia. – 2020. – Vol. 59. – P. 84–88. https://doi.org/10.1016/j.jclinane.2019.06.036.
13. Hernández-Porras B. C., Rocha A., Juarez A. M. Phenol spread in erector spinae plane block for cancer pain // Regional Anesthesia and Pain Medicine. – 2020. – Vol. 45, № 8. – P. 671. https://doi.org/10.1136/rapm-2019-100509.
14. Kot P., Rodriguez P., Granell M. et al. The erector spinae plane block: a nar rative review // Korean Journal of Anesthesiology. – 2019. – Vol. 72, № 3. – P. 209–220. https://doi.org/10.4097/kja.d.19.00012.
15. Leong R. W., Tan E. S. J., Wong S. N. et al. Efficacy of erector spinae plane block for analgesia in breast surgery: a systematic review and meta-analysis // Anaes thesia. – 2021. – Vol. 76, № 3. – P. 404–413. https://doi.org/10.1111/anae.15164.
16. Pirsaharkhiz N., Comolli K., Fujiwara W. et al. Utility of erector spinae plane block in thoracic surgery // Journal of Cardiothoracic Surgery. – 2020. – Vol. 15, № 1. – P. 91. https://doi.org/10.1186/s13019-020-01118-x.
17. Ragavendran S., Raghu C., Prasad S. R. et al. Comparison of epidural analgesia with ultrasound-guided bilateral erector spinae plane block in aorto-femoral arterial bypass surgery // Annals of Cardiac Anaesthesia. – 2022. – Vol. 25, № 1. – P. 2–33. https://doi.org/10.4103/aca.ACA_23_20.
18. Schwartzmann A., Peng P., Maciel M. A. at al. Mechanism of the erector spinae plane block: insights from a magnetic resonance imaging study // Canadian Anesthetists Society Journal. – 2018. – Vol. 65, № 10. – P. 1165–1166. https://doi.org/10.1007/s12630-018-1187-y.
19. Swisher M. W., Wallace A. M., Sztain J. F. et al. Erector spinae plane versus paravertebral nerve blocks for postoperative analgesia after breast surgery: a randomized clinical trial // Regional Anesthesia and Pain Medicine. – 2020. – Vol. 45, № 10. – P. 260–266. https://doi.org/10.1136/rapm-2019-101013.
20. Zhang Y., Liu T., Zhou Y. et al. Analgesic efficacy and safety of erector spinae plane block in breast cancer surgery: a systematic review and me ta-analysis // BMC Anesthesiology. – 2021. – Vol. 21. – P. 59. https://doi.org/10.1186/s12871-021-01277-x.
Review
For citations:
Smolyaninova D.S., Vorobyov D.V., Zimin M.V., Matsaev S.V. A clinical case of the use of an extended ESP block during simultaneous surgery in plastic surgery. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2025;22(4):102-107. (In Russ.) https://doi.org/10.24884/2078-5658-2025-22-4-102-107
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