Managing acute pancreatitis pain with bilateral erector spinae plane catheters in a patient allergic to opioids and NSAIDS: A case report.

Acute pancreatitis is one of the major causes of abdominal pain and is mainly related to either gallstone or heavy alcohol intake. We have managed a patient with acute pancreatitis with a bilateral erector spinae catheter because he was not suitable for other analgesics. A 72-year-old male with a known alcoholic patient was admitted with severe acute pancreatitis. He also had the chronic obstructive pulmonary disease (COPD) and oesophageal reflux disease. He was allergic to nonsteroidal anti-inflammatory medications and opioids. Therefore, his pain was managed successfully with bilateral erector spinae block with a continuous infusion with 0.125% levobupivacaine 1 ml/hr background infusion and 30 ml every 4 hours using a CADD Solis regional analgesia pump. Although erector spinae block is relatively new and to date, the optimal dose is not determined. We inserted the catheters at the T8 level; however, further study is needed to determine the ideal insertion site and drug volumes. We have mentioned key features, techniques, and management plans and reviewed the latest literature in this case report.