Erector spinae plane block for postoperative analgesia for above-the-knee amputation: a case report

Erica M Langnas; Andrew Gray; Matthias Braehler

doi:10.1186/s13741-022-00271-2

Erector spinae plane block for postoperative analgesia for above-the-knee amputation: a case report

Perioper Med (Lond). 2022 Jul 29;11(1):40. doi: 10.1186/s13741-022-00271-2.

Authors

Erica M Langnas^{1

2}, Andrew Gray³, Matthias Braehler⁴

Affiliations

¹ Department of Anesthesia and Perioperative Care, University of California, 8 Buchanan Street, Unit 808, San Francisco, CA, 94102, USA. Erica.Langnas@ucsf.edu.
² Department of Anesthesia and Perioperative Care, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, 8 Buchanan Street, Unit 808, San Francisco, CA, 94102, USA. Erica.Langnas@ucsf.edu.
³ Department of Anesthesia and Perioperative Care, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, 8 Buchanan Street, Unit 808, San Francisco, CA, 94102, USA.
⁴ Department of Anesthesia and Perioperative Care, University of California, 8 Buchanan Street, Unit 808, San Francisco, CA, 94102, USA.

Abstract

Background: Above-the-knee amputations (AKA) are common surgeries that frequently use neuraxial or peripheral nerve blocking techniques for both intraoperative and postoperative analgesia. It is not uncommon that patients present with contraindications to neuraxial anesthesia.

Case presentation: We identified a relatively novel use of erector spinae plane block (ESP) for above-the-knee amputation that allows for adequate pain control postoperatively when there are contraindications for neuraxial.

Conclusion: While data on ESP at the thoracic level is well described, less is known about the expected coverage for lumbar ESP. This case suggests that at the level of L3, there is sufficient dermatomal spread for an AKA.

Keywords: Above-the-knee amputation; Erector spinae plane block; Postoperative pain; Regional anesthesia.