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Bilateral Erector Spinae Plane Block for Man o' War Stings: A Case Report
1Mount Sinai Medical Center, Department of Emergency Medicine, Miami Beach, Florida.
Clinical Practice and Cases in Emergency Medicine
|March 1, 2023
Summary
Regional anesthesia, specifically an erector spinae plane block (ESPB), offers rapid and effective pain relief for Portuguese man o' war stings. This case highlights a novel approach to managing severe pain from Physalia physalis envenomation.
Area of Science:
- Marine Biology
- Emergency Medicine
- Anesthesiology
Background:
- Portuguese man o' war (Physalia physalis) stings are a common cause of cnidarian-related injuries globally.
- These stings inflict severe pain and skin irritation, posing challenges for effective pain management.
- Current treatment protocols lack standardized guidelines for pain control in Physalia stings.
Purpose of the Study:
- To report the successful use of regional anesthesia (RA) for managing pain associated with a Portuguese man o' war sting.
- To introduce the erector spinae plane block (ESPB) as a potential treatment modality for severe cnidarian envenomation.
Main Methods:
- A case report detailing the treatment of a 41-year-old female with a severe Portuguese man o' war sting.
- Application of regional anesthesia (RA) via an erector spinae plane block (ESPB) for pain management.
Main Results:
- The patient experienced rapid and sustained pain relief following the ESPB procedure.
- Regional anesthesia provided effective control of pain and skin irritation from the sting.
Conclusions:
- The standard of care for Physalia physalis sting pain management is not yet established.
- Regional anesthesia, particularly ESPB, should be considered by emergency physicians for treating Portuguese man o' war stings.
- This represents the first documented instance of ESPB use for cnidarian sting treatment.
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