The 66th
Scientific Meeting
초록접수 미리보기
| 18S-054 |
The successful application of the erector spinae plane block for the management of zoster-associated pain: a case series
가톨릭대학교 의과대학 마취통증의학 교실
Introduction: The ultrasound-guided erector spinae plane block (ESPB) is a recently described technique for providing thoracic analgesia and is a relatively simple and safe procedure. Central neuraxial block has been widely used to manage pain in herpes zoster in the thoracic level. In this report, we present the successful application of the ESPB for the management of zoster-associated pain.
Case 1: A 54-year-old male patient with no significant medical history was referred to our pain clinic with the chief complaint of right chest pain. The patient had been diagnosed with herpes zoster in the right T9 to T10 dermatome 3 weeks previously. The severity of his pain was 7/10 on a visual analogue scale (VAS). We performed an ultrasound guided ESPB with 20 ml of 0.6% lidocaine for pain control in the right T9 area. The VAS score decreased to 2/10. After 1 week, the severity of pain decreased from 7/10 to 2/10. A booster injection was performed. The patient’s pain remained at NRS 1-2 even after 2 months of follow-up.
Case 2: A 50-year-old male patient visited our pain clinic with pain due to herpes zoster in the left chest area. He reported that the stripes of blisters occurred in his left chest below the nipple area three days ago, along with severe pain in the left T5 to T6 dermatome. The patient underwent ultrasound guided ESPB with 20 ml of 0.6% lidocaine in the left T5 level. After 1 week, his pain severity decreased from 8/10 to 2/10. Another ESPB was performed as a booster injection. The patient was later seen at the 12-week follow up, and reported pain score of 1 out of 10.
Case 3: A 46-year-old female patient was referred to our clinic with pain in the right chest and back area. She had been diagnosed with herpes zoster in right T4 dermatome 2 months previous. The VAS score was 8/10. We proceeded with an ESPB using 20 ml of 0.6% lidocaine in the right T4 level. The VAS score decreased from 8/10 to 2/10. One week later, the ESPB was repeated on the same site. After 3 months of follow-up, she reported VAS score of 2/10 and affirmed that the pain had been well managed after the ultrasound-guided ESPB.
Conclusion: The ESPB is a simple and relatively less-invasive procedure compared to the central neuraxial blocks. It could be a good alternative treatment for the management of zoster-associated pain in the thoracic region.
Case 1: A 54-year-old male patient with no significant medical history was referred to our pain clinic with the chief complaint of right chest pain. The patient had been diagnosed with herpes zoster in the right T9 to T10 dermatome 3 weeks previously. The severity of his pain was 7/10 on a visual analogue scale (VAS). We performed an ultrasound guided ESPB with 20 ml of 0.6% lidocaine for pain control in the right T9 area. The VAS score decreased to 2/10. After 1 week, the severity of pain decreased from 7/10 to 2/10. A booster injection was performed. The patient’s pain remained at NRS 1-2 even after 2 months of follow-up.
Case 2: A 50-year-old male patient visited our pain clinic with pain due to herpes zoster in the left chest area. He reported that the stripes of blisters occurred in his left chest below the nipple area three days ago, along with severe pain in the left T5 to T6 dermatome. The patient underwent ultrasound guided ESPB with 20 ml of 0.6% lidocaine in the left T5 level. After 1 week, his pain severity decreased from 8/10 to 2/10. Another ESPB was performed as a booster injection. The patient was later seen at the 12-week follow up, and reported pain score of 1 out of 10.
Case 3: A 46-year-old female patient was referred to our clinic with pain in the right chest and back area. She had been diagnosed with herpes zoster in right T4 dermatome 2 months previous. The VAS score was 8/10. We proceeded with an ESPB using 20 ml of 0.6% lidocaine in the right T4 level. The VAS score decreased from 8/10 to 2/10. One week later, the ESPB was repeated on the same site. After 3 months of follow-up, she reported VAS score of 2/10 and affirmed that the pain had been well managed after the ultrasound-guided ESPB.
Conclusion: The ESPB is a simple and relatively less-invasive procedure compared to the central neuraxial blocks. It could be a good alternative treatment for the management of zoster-associated pain in the thoracic region.
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