Hepatopancreaticobiliary (HPB) surgery is major upper abdominal surgery with considerable risk of pulmonary complications related to postoperative pain. While epidural analgesia remains an effective analgesic technique for upper abdominal surgery, HPB surgery poses challenges to its use due to coagulopathy. Erector spinae plane (ESP) blocks are a promising alternative to epidurals. Injection of local anesthetic deep to the erector spinae muscle plane and placement of a catheter for prolonged effect provide both somatic and visceral analgesia for both thoracic and abdominal surgery. We describe a series of 3 cases that illustrate the efficacy of ESP blocks after major HPB surgery.
From the Department of Anesthesia and Intensive Care Medicine, St Vincent’s University Hospital, Elm Park, Dublin, Ireland.
Accepted for publication June 20, 2019.
The authors declare no conflicts of interest.
Address correspondence to Shrijit Nair, FCAI, Department of Anesthesia and Intensive Care Medicine, St Vincent’s University Hospital, Elm Park, Dublin 4, Ireland. Address e-mail to firstname.lastname@example.org.