Continuous Erector Spinae Plane Block for Refractory Chest Wall Pain in a Patient With Metastatic Breast Cancer: A Case Report.

In this case report, we described the use of the continuous erector spinae plane (ESP) block in a patient presenting with severe chest wall pain due to terminal metastatic breast cancer. Her pain was refractory to most treatment modalities despite being on huge doses of parenteral opioids for 6 months. A single shot ESP block was initially trialed, which provided her complete pain relief. This was followed by an ESP catheter insertion and continuous infusion of local anesthetic, which helped her wean off the parenteral opioids over the next 4 days. She was discharged home with the catheter in situ, attached to a delivery pump.