Erector spinae plane block facilitating rapid weaning in an anticoagulated V-V ECMO patient with chest trauma

IntroductionWe report the successful use of erector spinae (ESP) plane block in the management of a patient with severe respiratory failure secondary to chest trauma requiring invasive ventilation and Veno-venous extracorporeal membrane oxygenation (V-V ECMO).Case reportA 64-year-old man with flail chest and severe respiratory failure required V-V ECMO. An ESP plane block on day 3 enabled extubation, mobilisation, and secretion clearance, leading to ECMO weaning after six days and discharge 18 days post-injury.DiscussionThis case demonstrating that regional anaesthesia is a safe, feasible option for improving ventilatory mechanics after chest trauma. It can facilitate awake ECMO, enhanced physiotherapy and liberation from respiratory support. Keywords: erector spinae plane block/ESP block, V-V ECMO, chest trauma, regional anaesthesia, severe respiratory failure.