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Inicio Revista Española de Anestesiología y Reanimación (English Edition) Bilateral erector spinae plane block for scoliosis surgery: Case series
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Vol. 67. Issue 3.
Pages 153-158 (March 2020)
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Vol. 67. Issue 3.
Pages 153-158 (March 2020)
Case report
Bilateral erector spinae plane block for scoliosis surgery: Case series
Bloqueo bilateral en el plano del músculo erector de la columna para cirugía de escoliosis: serie de casos
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S.M. Diwana,
Corresponding author
sdiwan14@gmail.com

Corresponding author.
, E. Yamak Altinpullukb,c, K. Khurjekara, A. Naird, H. Dongrea, A. Turanb
a Sancheti Hospital, Pune, India
b Outcomes Research Department, Anesthesiology Institute, Cleveland Clinic, OH, United States
c Department of Anesthesiology and Reanimation, Istanbul University-Cerrahpaşa, Cerrahpasa Medical Faculty, Estambul, Turquia
d Basavatarakam Indo-American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
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Tables (4)
Table 1. Summary of demographic data, including Cobb angle, of 6 patients.
Table 2. Injection sites on the concave and convex sides and total volume/dose of local anaesthetic.
Table 3. Total use of propofol and dexmedetomidine and total fentanyl consumption.
Table 4. Pain on the numerical rating scale pain during the first 48 postoperative hours.
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Abstract

Spinal correction surgery is a very invasive surgical procedure and results in severe postoperative pain. We report six cases in which Bilateral Erector Spinae Plane Block was performed for scoliosis surgery. Our aim was to provide an effective perioperative pain management and to achieve intraoperative hemodynamic stability with no interference on neuromonitoring. The technical challenges are also highlighted. An ultrasound guided scout scan is necessarry to identify the bony prominences and determine the possible multiple injection points. Erector Spinae Plane Block in scoliosis surgery is an easier and safer technique compared to epidural anesthesia and can use instrumented complex spinal surgery. This block seems to have a role in perioperative pain pathway complementing the multimodal analgesic regimen and not have interference with evocated potentials in adults. However the diffusion mechanism of the this block is not well known hence it should be awake regarding local anesthetic toxicity.

Keywords:
Scoliosis surgery
Erector spinae block
Regional anesthesia
Resumen

La cirugía de corrección de la columna es un procedimiento quirúrgico invasivo, que origina daño postoperatorio severo. Reportamos seis casos de bloqueo en el plano del músculo erector de la columna para cirugía de escoliosis. Nuestro objetivo fue aportar tratamiento efectivo para el dolor perioperatorio, y lograr estabilidad hemodinámica intraoperatoria, sin interferir en la neuromonitorización. También se destacan los retos técnicos. El escáner ecoguiado es necesario para identificar las prominencias óseas y determinar los posibles puntos de inyección múltiples. El bloqueo en el plano del músculo erector de la columna en cirugía de escoliosis es una técnica más fácil y segura, en comparación con la anestesia epidural, pudiendo utilizar cirugía de columna compleja instrumentada. Este bloqueo parece jugar un papel en la vía del dolor perioperatorio, complementando el régimen anestésico multimodal, y no interfiriendo en los potenciales evocados en adultos. Sin embargo, el mecanismo de difusión de este bloqueo es poco conocido aún y, por tanto, debemos ser conscientes de la toxicidad del anestésico local.

Palabras clave:
Cirugía de escoliosis
Bloqueo en el plano del músculo erector de la columna
Anestesia regional

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