T4 Erector Spinae Plane Block Relieves Postdural Puncture Headache: A Case Report
Johanna B De Haan1, Olga M Chrisman1, Linden Lee1
1Anesthesiology, McGovern Medical School University of Texas Health Science Center, Houston, USA.
Cureus
|December 7, 2019
Summary
Postdural puncture headache (PDPH) can be effectively treated with an erector spinae plane (ESP) block. This novel approach offers an alternative for patients unwilling or unable to undergo traditional epidural blood patch procedures.
Area of Science:
- Anesthesiology
- Pain Management
- Neurology
Background:
- Postdural puncture headache (PDPH) is a frequent complication following neuraxial anesthesia.
- The standard treatment, epidural blood patch (EBP), carries risks and may face patient reluctance.
- Alternative treatments are needed, especially for complex patient populations.
Observation:
- The erector spinae plane (ESP) block has shown efficacy in various pain conditions.
- A prior case series suggested ESP block for tension headaches.
- This report details its use in a super morbidly obese patient with PDPH.
Findings:
- An erector spinae plane (ESP) block at the T4 vertebral level successfully relieved PDPH.
- The procedure was performed in a patient with significant comorbidities and a history of dural punctures.
- This represents a novel application of the ESP block for PDPH management.
Implications:
- The ESP block may serve as a viable, less invasive alternative to EBP for PDPH.
- This technique could be particularly beneficial for patients with contraindications or aversion to EBP.
- Further research is warranted to establish the broader efficacy and safety of ESP block for PDPH.
