Postoperative Analgesia Using Multiple Erector Spinae Plane Catheters in a Single-Stage Surgery for Synchronous...

Area of Science:

• Anesthesiology
• Surgical Oncology
• Pain Management

Background:

• Synchronous breast and colon cancers require complex surgical management.
• Effective postoperative analgesia is crucial for enhanced recovery after surgery (ERAS) protocols.
• Erector spinae plane block (ESPB) is an emerging regional anesthesia technique.

Purpose of the Study:

• To evaluate the efficacy and safety of multicatheter ESPB for postoperative analgesia in a patient with synchronous breast and colon cancers.
• To assess the feasibility of integrating ESPB into ERAS pathways for complex, multi-site surgeries.

Main Methods:

• A 60-year-old female patient underwent single-stage left mastectomy and laparoscopic right hemicolectomy.
• Three ESPB catheters were placed (T4 left, T9 bilateral) post-induction.
• Continuous infusion of ropivacaine was administered via programmed intermittent bolus.

Main Results:

• Effective thoracoabdominal analgesia was achieved.
• Postoperative opioid consumption was significantly minimized.
• Early patient mobilization was successful without any block-related complications.

Conclusions:

• Multicatheter ESPB offers a safe and effective option for managing thoracoabdominal pain in complex, synchronous surgical procedures.
• This technique supports ERAS principles by improving pain control and facilitating early recovery.
• ESPB demonstrates versatility for managing pain across different anatomical regions in major oncologic surgery.