Pain medicine case reports · 2023
Motor Blockade After Erector Spinae Plane Block for Lumbar Spinal Surgery: A Case Report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shearer Dylan, Kamyszek Reed W, Kapoor Trishul, Saggu Jay, Li Grace, Chiravuri Srinivas
Аннотация
BACKGROUND: Regional anesthetic techniques, including the erector spinae plane block (ESPB), decrease pain scores while reducing opioid consumption. Given their high safety profile and analgesic efficacy, ESPBs offer an alternative to neuraxial anesthetic techniques for perioperative analgesia.
CASE REPORT: Transient unilateral dense L3 motor weakness occurred as a complication of the ESPB performed intraoperatively for an L2-L5 laminectomy and L2-L3 discectomy at the L3 level. The motor weakness was concerning for spinal cord injury and confounded the postoperative neurologic examination.
CONCLUSIONS: Lesson learnt from this case suggests the lumbar ESPB should be performed preoperatively in awake patients to avoid confounding physical exam findings in the postoperative anesthesia care unit; this also reduces the need for further emergent imaging and workup. During a lumbar ESPB, a local anesthetic should be deposited at the tip of the transverse process, and not breach the intertransversarii muscle and ligament to favor the dorsal spread and sparing of ventral rami motor fibers.
CASE REPORT: Transient unilateral dense L3 motor weakness occurred as a complication of the ESPB performed intraoperatively for an L2-L5 laminectomy and L2-L3 discectomy at the L3 level. The motor weakness was concerning for spinal cord injury and confounded the postoperative neurologic examination.
CONCLUSIONS: Lesson learnt from this case suggests the lumbar ESPB should be performed preoperatively in awake patients to avoid confounding physical exam findings in the postoperative anesthesia care unit; this also reduces the need for further emergent imaging and workup. During a lumbar ESPB, a local anesthetic should be deposited at the tip of the transverse process, and not breach the intertransversarii muscle and ligament to favor the dorsal spread and sparing of ventral rami motor fibers.