NYSORA 4 U (N4U): What’s New
An Anatomical Study Comparing Two Approaches to the Erector Spinae Plane Block
Prior studies highlight variable anterior spread with erector spinae plane (ESP) blocks, often due to imprecise needle placement. This cadaveric study introduces two novel ESP block techniques: one targeting the medial aspect of the transverse process and the other between the lateral ends of the transverse processes. Results indicate superior anterior spread with injections between transverse processes than with medial transverse process injections. This suggests that ESP blocks entering the intertransverse tissue complex may enhance anterior spread. Further clinical research is warranted to confirm whether this approach improves clinical efficacy and outcomes compared to conventional ESP blocks.
Laminectomy dissection of an injection between transverse processes. (A) Blue vessel loops indicate nerve roots. White dotted line shows cut margins of the dural sac. (B) Dural sac is reflected to show spinal cord and intrathecal nerve roots. DRG, dorsal root ganglion.
To read the full paper in RAPM, copy-paste this into your Google search:
Harbell MW, Langley NR, Seamans DP, et al. Evaluating two approaches to the erector spinae plane block: an anatomical study. Reg Anesth Pain Med. 2023;48(10):495-500.
