“Combined Superior trunk block and Erector spinae plane block for scapular resection: Amalgamation of two blocks for effective analgesia!”

Document Type : Letter to the Editor

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Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India.

Abstract

Peripheral nerve blocks (PNB) have gained widespread acceptance as technological advancements have improved accuracy, efficacy, and safety. PNBs offer many advantages to traditional anesthetic and analgesic techniques. Patients who would otherwise have excessive risks with general anesthesia can safely undergo surgery painlessly with regional anesthesia. Additionally, perioperative opioid analgesia's adverse effects can be minimized or avoided entirely while still providing superior pain control. If a prolonged blockade is a goal, peripheral nerve catheters can remain for several days to provide more extended analgesia than a single-shot block alone. The large, complex, and convoluted innervation of the scapula makes it difficult to provide surgical anesthesia for scapular surgery; a single block is insufficient.
Superior trunk block (STB) , is a novel brachial plexus block technique that provides surgical anesthesia with significantly rare hemidiaphragmatic paralysis. The Erector Spinae Plane block (ESPB) is a paraspinal fascial plane block in which the needle placement is between the erector spinae muscle and the thoracic transverse processes, and a local anesthetic is administered, blocking the dorsal and ventral rami of the thoracic and abdominal spinal nerves. We report the use of STB in conjunction with ESPB to provide adequate analgesia following scapulectomy.

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