Exploring the Potential of Lidocaine in a Bilateral Erector Spinae Plane Block for Multimodal Analgesia in Partial Hepatectomy: A Case Report

Cureus. 2023 Jun 6;15(6):e40047. doi: 10.7759/cureus.40047. eCollection 2023 Jun.

Abstract

The bilateral erector spinae plane block (ESP) has been effectively used for abdominal surgery, and the placement of catheters is known to extend the benefits of the block while allowing for the adjustment of local anesthetic doses as necessary. Since fascial plane blocks require high volumes of local anesthetic and a prolonged duration of effect, typically, long-acting local anesthetics are preferred. However, lidocaine is not commonly chosen for these types of blocks due to the large volumes required and the associated risk of local anesthetic systemic toxicity. Nonetheless, we present a case report of a patient who underwent a partial hepatectomy under general anesthesia, with perioperative placement of a bilateral ESP block. Bilateral catheters were inserted, and 1% lidocaine was selected as the local anesthetic due to resource limitations. The surgery proceeded without complications, and the patient reported effective analgesia and a high level of satisfaction. Our report suggests that the utilization of lidocaine in a continuous ESP block can be a successful alternative for partial hepatectomies.

Keywords: erector spinae plane block; lidocaine; multimodal analgesia; partial hepatectomy; resource limitations.

Publication types

  • Case Reports