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Thoracic Erector Spinae Plane (T-ESP) Block Together With Intertransverse Process (ITP) Block for Laparoscopic
Carmine Pullano1, Francesco Marrone2, Saverio Paventi2
1Anesthesia, Villa Pia Clinic, Rome, ITA.
Cureus
|January 24, 2024
Summary
This study explored combining erector spinae plane (ESP) and intertransverse process (ITP) blocks for laparoscopic surgery anesthesia. The novel technique provided effective pain control for a patient refusing general anesthesia.
Area of Science:
- Anesthesiology
- Regional Anesthesia
- Surgical Pain Management
Background:
- Laparoscopic surgery offers reduced stress and pain.
- Erector spinae plane (ESP) blocks are recognized for abdominal surgery analgesia.
- Thoracic paravertebral blocks provide abdominal analgesia via local anesthetic administration.
Observation:
- A 42-year-old male patient with GERD, difficult airway history, and ASA-PS 2 status was scheduled for laparoscopic Nissen fundoplication.
- The patient refused general anesthesia.
- Bilateral thoracic ESP/ITP blocks were performed at the T4-8 level under sedation.
Findings:
- The combined ESP-ITP block technique was successfully employed for laparoscopic Nissen fundoplication.
- The patient underwent surgery with spontaneous breathing and sedation without complications.
- The anesthesia approach provided optimal postoperative pain control with no reported side effects.
Implications:
- The combination of ESP and ITP blocks presents a viable anesthesia option for laparoscopic procedures.
- This technique may be particularly beneficial for patients who cannot undergo general anesthesia.
- Further research into multi-dermatomeric paravertebral blocks for surgical anesthesia is warranted.
