Paraparesis After Ultrasound-Guided Lumbar Erector Spinae Plane Block: A Case Report and Review.

BACKGROUND

Erector spinae plane block (ESPB) is an interfascial block used to manage perioperative acute and chronic pain. Local anesthetics administered during the procedure may occasionally cause temporary motor block.

CASE REPORT: A 39-year-old woman presented with low back and right leg pain due to lumbar disc herniation. Her neurological examination was normal. Under ultrasound guidance, ESPB was performed at the right L4 level using 20 mL of a solution containing bupivacaine, saline, and dexamethasone. Fifteen minutes later, she had decreased motor strength in the right lower extremity and mild weakness on the left. Muscle strength and sensation returned to normal within 18 hours.

CONCLUSIONS

Evidence concerning ESPB complications and the optimal volume and concentration of local anesthetic remains limited. Further research is needed to evaluate its safety.