Purpose of Review

The erector spinae plane block (ESPB), first described in 2016, offers the promise of becoming a safe, less invasive, and technically less demanding alternative to conventional thoracic regional anesthetic techniques including thoracic epidurals and traditional paravertebral blocks. Clinical and cadaveric studies suggest that ESPB acts on the ventral rami of spinal nerves in the paravertebral space via penetration of the intertransverse connection tissues and moreover achieves visceral analgesia via the rami communicantes and sympathetic chain.

Recent Findings

The block has garnered considerable appeal related to an inherently lower risk of neurovascular and pleural injury, low risk of local anesthetic systemic toxicity, and relative technical simplicity in comparison with epidural or paravertebral blockade. It has been utilized in the treatment of acute perioperative pain in a variety of clinical applications including breast, thoracic, and abdominal surgeries and trauma and may even offer some benefit in spine surgery.

Summary

Given the combination of its efficacy and decreased associated risk when performed for perioperative pain, use of ESPB should be further explored for the management of chronic pain. Current literature at this time is limited to case studies and series performed by select groups. Though it is important to consider ESPB for chronic pain, further studies are needed to evaluate the efficacy and safety of the ESPB in the management of both acute and chronic pain.

中文翻译：

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脊柱平面阻滞器在术后和慢性疼痛管理中的作用不断扩大。

审查目的

竖脊椎平面阻滞（ESPB）于2016年首次描述，它有望成为一种安全，侵入性小，技术上要求不高的替代方法，可替代传统的胸腔区域麻醉技术，包括胸膜硬膜外麻醉和传统的椎旁阻滞。临床和尸体研究表明，ESPB通过横向连接组织的穿透作用作用于椎旁间隙中脊神经的腹横肌，此外，还通过横肠交感神经和交感神经链实现内脏镇痛。

最近的发现

与硬膜外或椎旁阻滞相比，该阻滞获得了相当大的吸引力，与神经血管和胸膜损伤的固有风险较低，局部麻醉剂全身毒性的低风险以及相对的技术简便性有关。它已被用于各种临床应用中的急性围手术期疼痛的治疗，包括胸部，胸部和腹部手术以及创伤，甚至可能在脊柱手术中提供一些益处。

概要

鉴于其疗效和降低的围手术期疼痛风险相结合，应进一步探索使用ESPB治疗慢性疼痛。目前，当前文献仅限于案例研究和特定小组进行的系列研究。尽管考虑将ESPB用于慢性疼痛很重要，但仍需要进一步研究以评估ESPB在急性和慢性疼痛管理中的功效和安全性。