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Crossing the midline: How the unilateral erector spinae plane block may provide bilateral visceral analgesia
Richard J Gawel1, Daniel M DePietro2, Nicole A Robinson3
1Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Abstract:
The erector spinae plane block (ESPB) is frequently performed for a variety of indications both in the perioperative setting and the emergency department (ED). There remains controversy, however, regarding whether a single unilateral ESPB can provide bilateral visceral analgesia. In this discourse, we discuss the anatomical basis of the ESPB and describe several potential mechanisms for how a large volume unilateral thoracic ESPB may provide analgesia to the abdominal viscera to manage a variety of painful conditions encountered in the ED.
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