The Erector Spinae Block- for patients
- Jen Overton
- Jan 2
- 4 min read
Updated: Sep 22
Feeling informed and knowing what to expect prior to your procedure can help tremendously decrease anxiety. As someone who has spent years in the field of anesthesia, I understand the importance of patients feeling informed and comfortable before surgery.
Here we will learn about the Erector Spinae block (ESP Block). This post is geared toward patient information for the general public, hence the title, "The Erector Spinae Block- for patients." In this post, I’ll explain what to expect from this block, its purpose, the areas it affects, and the process of placement. My goal is to provide you with a clear understanding and peace of mind.
Purpose of the Erector Spinae Block
The Erector Spinae Block is primarily used to provide pain relief for surgeries involving the chest, including breast surgery or thoracic procedures like video-assisted thoracoscopy (VATS). By delivering local anesthetic near the erector spinae muscles, this block targets the spinal nerves that supply sensation to the chest wall. Local anesthesia (numbing medications) delivered in this way can significantly reduce postoperative pain, allowing for a smoother recovery.
Benefits of the Erector Spinae Block
1. Reduced Opioid Use: Studies have shown that the ESP block can decrease the need for opioid (narcotic) pain medications both during and after surgery. Since opioid pain medication are known to cause side effects like nausea and constipation, it is extremely helpful to be able to avoid these drugs if possible. Employing a block like the ESP block can make recovery much smoother (Kot, P. et al., 2019).
2. Improved Pain Control: Research also indicates that patients who receive an ESP block report lower pain scores and enhanced comfort after surgery (Qurat, et al., 2024). This can lead to a faster ability to move around and recover from the surgery and from the anesthesia gas.
Regions of the Chest Affected by the ESP Block
The Erector Spinae Block provides anesthesia and numbness to various regions of the chest, including:
- Anterior Chest Wall: This includes the area over the sternum and the rib cage, which is often necessary for surgeries in the thoracic region.
- Lateral Chest Wall: The block can help numb the sides of the chest, which is beneficial for procedures that may involve lateral incisions.
- Upper Abdomen: Depending on the specific placement, the block may also provide some coverage to the upper abdominal area.
Process of ESP Block Placement
Understanding the process of how the Erector Spinae Block is placed can help alleviate any concerns you may have and help you to be more mentally prepared for what to expect:
1. Seating Position: You’ll be asked to sit up on the stretcher, similar to how you might sit on a park bench. This position allows easy access to your back while ensuring your comfort and safety.
2. Sedation Administration: To minimize any discomfort or anxiety during the procedure, sedation medication will be administered through an IV. This helps you feel relaxed and at ease.
3. Oxygen Supply: Any time sedation medication is administered, nasal cannula oxygen will always be placed to provide supplemental oxygen to your body, ensuring you remain comfortable and safe after throughout the procedure.
4. Preparation of the Back: The area of your back where the block will be placed will be prepped with cleansing solution and a drape will be applied to maintain a sterile environment.
5. Numbing the Skin: A small amount of local anesthetic (numbing medicine) will be applied to the top layer of your skin to minimize any discomfort when the deeper block is placed.
6. Ultrasound Guidance: An ultrasound probe is utilized to visualize the spine and surrounding structures. This ensures that the anesthesia provider can accurately locate the best spot for delivering the medication. Having an ultrasound of the area is completely painless.
7. Delivery of Anesthetic: Once the optimal site is identified, a local anesthetic medication is injected near the erector spinae muscles, blocking the spinal nerves that provide sensation to the targeted regions (chest).
Remember that just like any block, this effect is temporary. The numbing medicine will eventually wear off, but hopefully, this block will help you stay very comfortable for several hours after your procedure.
Did your doctor mention Erector Spinae block for an upcoming mastectomy? Click the image to read Anesthesia Expectations for Mastectomy Surgery (with or without reconstruction).
Conclusion
The Erector Spinae Block is a valuable tool in providing effective pain relief for surgeries involving the chest. By understanding what to expect during the procedure—from seating position to the use of ultrasound guidance—you can feel more at ease knowing you are in capable hands.
If you have any questions or concerns about the Erector Spinae Block or your upcoming surgery, please don’t hesitate to reach out to your healthcare team. They are there to support you and ensure that your experience is as comfortable and anxiety-free as possible. You can also search worryfreeanesthesia.com for information regarding anesthesia for your procedure.
Still feeling anxious about anesthesia? Click the image below to read How to Overcome the Fear of Anesthesia: Tips for a Better Surgery Experience.
Want to learn more about anesthesia? Click on the logo below to view more Articles. Prepared Patients: Better Outcomes!
References
- Kot, P., et al. (2019). The erector spinae plane block: a narrative review. Korean Journal of Anesthesiology. https://pmc.ncbi.nlm.nih.gov/articles/PMC6547235/
-Qurat, U. A. M. (2024). Analgesic efficacy and safety of erector spinae versus serratus anterior plane block in thoracic surgery: a systematic review and meta-analysis of randomized controlled trials. Journal of Anesthesia, Analgesia, and Critical Care.
**Information provided is intended as general healthcare information for the public and should be used as a guide. This information should not be substituted for the specific personal advice recommended by your own healthcare team who are familiar with your specific health history.*
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