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Published on: January 20, 2012
Differences in Clinical Efficacy of Erector Spinae Plane Block Performed at the Medial and Lateral Transverse
Chen Chen1, Hongyan Dai2, Xiaoyang Jiang1
1Department of Anaesthesiology, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
Objective:
To compare the clinical efficacy of erector spinae plane block (ESPB) administered at the medial versus lateral aspect of the fifth thoracic transverse process (TP) apex and to investigate the potential influence of the intermuscular partitioning fascia (IMPF) on medicine diffusion.
Study Design:
Randomised controlled trial. Place and Duration of the Study: Department of Anaesthesiology, Affiliated Cancer Hospital of Xinjiang Medical University, Xinjiang, China, from August 2023 to April 2024.
Methodology:
Twenty patients undergoing thoracic surgery were randomly allocated to the medial TP apex group (M Group, n = 10) or lateral TP apex group (L Group, n = 10). ESPB was performed at the T5 level, and sensory blockade regions were evaluated 30 minutes post-injection.
Results:
All patients in the M Group (10/10) exhibited sensory blockade covering the posterior midline to 2 cm laterally (L group: 0/10, p <0.001). The M Group also demonstrated a significantly higher blockade rate at the T11-T12 region (7/10 vs. 1/10, p = 0.020). Anatomical analysis indicated that the IMPF at the TP apex segregated medial and lateral medicine diffusion pathways.
Conclusion:
ESPB administered at the medial TP apex provides a broader blockade range, potentially mediated by the IMPF restricting multidirectional medicine diffusion. This fascial barrier may influence clinical efficacy by directing medicine spread.
Key Words:
Erector spinae plane block, Transverse process, Ultrasound-guided, Fascial barrier, Sensory blockade.
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