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Erector Spinae Plane Block in Open Appendectomy: A Case Series.
Jassim Rauf1,2, Mohammad Mohsin A M Haji1
1Department of Anesthesiology, ICU & Perioperative Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
Case Reports in Anesthesiology
|July 3, 2025
Summary
This case series suggests that the erector spinae plane block (ESPB) may reduce opioid use during and after open appendicectomy. Both patients experienced significant pain relief, with one achieving complete morphine-free analgesia.
Area of Science:
- Anesthesiology
- Pain Management
- Surgical Procedures
Background:
- Open appendicectomy necessitates multimodal analgesia to manage significant pain.
- Previous methods like TAP block and local infiltration have reduced opioid consumption.
- The erector spinae plane block (ESPB) is explored for its opioid-sparing potential in this context.
Observation:
- Two patients undergoing open appendicectomy received general anesthesia (GA) followed by an ESPB at the T12 level.
- Pain scores were assessed using the Numerical Rating Scale (NRS) in the post-anesthesia care unit (PACU) and up to discharge.
- Analgesic adjuncts varied between patients due to clinical factors.
Findings:
- Both patients reported a 0 NRS pain score in the PACU.
- One patient maintained a 0 NRS pain score until discharge, indicating complete morphine-free analgesia.
- The other patient reported a maximum NRS score of 5/10, demonstrating significant pain reduction.
Implications:
- ESPB shows promise as an effective component of multimodal analgesia for open appendicectomy.
- This technique may offer substantial opioid-sparing benefits, potentially leading to morphine-free intra- and postoperative periods.
- Further research is warranted to confirm the efficacy and generalize findings of ESPB in open appendicectomy pain management.
