Ultrasound-Guided Erector Spinae Plane Block for Refractory Chest and Epigastric Pain Control in Sickle Cell Crisis:...

This report aims to demonstrate the potential role of ultrasound-guided erector spinae plane block (ESPB) in managing refractory epigastric and chest pain due to vaso-occlusive crises (VOCs). An 18-year-old girl with sickle cell disease (SCD) presented to the emergency department with refractory epigastric and chest pain due to VOC. An ultrasound-guided left-sided erector spinae plane block (ESPB) using 30 mL of 0.2% ropivacaine provided rapid and sustained analgesia, reducing her Numerical Rating Scale (NRS) pain score from 8/10 at baseline to 0/10 at 2 hours postblock. She remained pain-free at 24 hours of follow-up and required no additional systemic opioids during a 48-hour inpatient observation period, suggesting ESPB feasible, opioid-sparing adjunct for thoracoabdominal VOC pain.