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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Erector spinae plane block for radical mastectomy: A new indication?
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Vol. 65. Issue 2.
Pages 112-115 (February 2018)
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Vol. 65. Issue 2.
Pages 112-115 (February 2018)
Case report
Erector spinae plane block for radical mastectomy: A new indication?
Bloqueo en el plano del músculo erector de la columna para mastectomía radical: ¿una nueva indicación?
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M. Veiga
Corresponding author
nocas_veiga@hotmail.com

Corresponding author.
, D. Costa, I. Brazão
Servicio de Anestesiología, Hospital Central do Funchal, Funchal, Portugal
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Abstract

The erector spinae plane block is a technique recently described by Forero et al. in September 2016. It has applications in the control of chronic pain with neuropathic component of the chest wall, and for pain control in thoracoscopic surgery. In this article, we describe the use of this technique as part of a multimodal analgesic approach in a 40-year-old woman, who underwent radical mastectomy due to breast cancer. By performing this block before anesthetic induction, we have achieved an opioid sparing effect, avoiding a possible immunomodulatory effect, although not yet proven in humans. During hospitalization, the patient reported no pain (0/10 in numeric scale), without resorting to rescue analgesia. The easy, fast and safe execution of erector spinae plane block makes it a promising technique in the context of surgical pain during radical mastectomy.

Keywords:
Regional anesthesia
Pain management
Mastectomy
Erector spinae
Resumen

El bloqueo de la fascia del músculo erector de la columna es una técnica recientemente descrita por Forero et al. en septiembre de 2016. Tiene aplicaciones en el control del dolor crónico con componente neuropático de la pared torácica, y para el control del dolor en cirugía toracoscópica. En este artículo, describimos el uso de esta técnica como parte de un enfoque analgésico multimodal en una mujer de 40 años, que fue sometida a una mastectomía radical a causa de un cáncer de mama. Al realizar este bloqueo antes de la inducción anestésica, conseguimos un efecto ahorrador de opioides, evitando el posible efecto inmunomodulador, que todavía no está comprobado en humanos. Durante la hospitalización, la paciente no reportó dolor (0/10 en escala numérica), sin recurrir a analgesia de rescate. La ejecución fácil, rápida y segura del bloqueo de la fascia del músculo erector de la columna hace que esta sea una técnica prometedora en el contexto del dolor quirúrgico durante la mastectomía radical.

Palabras clave:
Anestesia regional
Terapéutica del dolor
Mastectomía
Erector spinae

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