Erector Spinae Plane (ESP) Block

Рет қаралды 260,283

Regional Anesthesiology and Acute Pain Medicine

Күн бұрын

In this video, we discuss the anatomy, mechanism, and technique for thoracic and lumbar ESP block, and share some tips for success when performing this block

Пікірлер: 47

@deman601 2 жыл бұрын

Thank you-your vídeos are extremely well done and your tips and pearls are helpful and pertinent to actual practice-other video producers should learn from you!

@nathanek6598 3 ай бұрын

Excellent tutorial, great visuals and narration!

@Joclaim1 2 жыл бұрын

Great presentation. Well done

@winterpark02 Жыл бұрын

Excellent teacher . Great presentation

@francoislouw6764 Жыл бұрын

Excellent video on ESP. This general technique is also helpful in interventional treatments for chronic pain (eg. thoracic facet syndrome/ costotransverse joint pathology).

@keithh7510 Жыл бұрын

Love that smoke narration!

@gabrun5441 8 ай бұрын

Excellent video and very well explained

@SamtaniPradeep Жыл бұрын

Excellent video presentation Sir. Make us fall in love with ESP in just 8minutes Thanks a tonne Sir

@ahmadtga1 3 жыл бұрын

Excellent presentation

@thesimplewonders1918 2 жыл бұрын

Very helpful thank you so much

@dcDOC19 3 жыл бұрын

I had no idea the ESP was useful for abdominal surgery... Very cool! Thanks!

@tazkirah88 Жыл бұрын

I've done ESP for laparotomy n bowel resection.. I would say, excellent as I didn't give any morphine intra-op

@paanmelaka 5 ай бұрын

@@tazkirah88may i know how much volume and drug concentrations you usually use? thank you

@drtanveerahmed4585 3 жыл бұрын

ESP block is Darling ...One Block covers everything. So beautiful.

@tazkirah88 Жыл бұрын

Did u hv experience ESP for lower limb surgeries?

@DushyantsCHANNEL 2 күн бұрын

Plenty! It's great for it. Since it mostly covers dorsal ramus @@tazkirah88

@hishighnessab5540 11 ай бұрын

Thanks for the informative video. For pancreatitis pain relief which side should be blocked?

@kimyuichii4303 3 жыл бұрын

will it be also effective for chest wall lesion post-herpetic neuralgia?

@loyalcynic772 2 жыл бұрын

great video

@GeneCircuit Жыл бұрын

If the TP is difficult to visualize, but the rib slightly lateral to the TP is super easy to see, if you choose to inject instead on top of the rib, how effective would this be? Would you block dorsal rami and miss the paravertebral space spread? Or would you get roughly equal efficacy compare to ESP?

@sthakur66901 3 жыл бұрын

thanks

@alvaroalfaro9478 4 ай бұрын

Is the erector spinar plane continuous to the retrolaminar region more medially? If so, would placement of a retrolaminar block also work just about as well with lesser chance of penetrating past bone since the laminae provide a continuous row of bone with much smaller gaps? You would simply stay closer to midline. I've read about use of retrolaminar block in pain clinic but never as applied for postop pain. Thanks

@tazkirah88 Жыл бұрын

Do u have any experience using ESP for lower limb surgeries? Especially ESP as whole anaesthesia, not as analgesia?

@drsevrin100 2 жыл бұрын

Would an L3 block work for sciatica pain?

@raimundonascimento2861 3 жыл бұрын

Show! 👏🏾 👏🏾 👏🏾 👏🏾

@josefstrenk8597 2 жыл бұрын

Is ESP worth as single shot? How long does the analgesia last without a catheter?

@mahdijallad2372 2 жыл бұрын

How long does analgesia after a single shot last? Do you use any adjunctive meds to enhance quality and prolong duration of the block? Would you use Exparel with this block? Thank you!

@tropiex2097 2 жыл бұрын

Olso I’m interested to this answer!

@var3180 3 жыл бұрын

how is your needle visualised so well at that angle with the lumbar example?

@asyahmi3732 3 жыл бұрын

My toughts exactly.. what type of needle is that

@chachachachaching 3 жыл бұрын

I think the curvilinear probe certainly helps

@SamtaniPradeep Жыл бұрын

Sir can you make videos on newer Sacral ESP and Cervical ESP blocks?? It'll be a lot of help to us Sir

@camosquid5114 2 жыл бұрын

Have you used exparel for Thoracic level ESP blocks? Any issues of Exparel or marcaine behaving like an epidural?

@JustSayN2O 3 жыл бұрын

Have you been administering bilateral blocks for, say, non-robotic (!) open abdominal surgery?

@tazkirah88 Жыл бұрын

I've done it for open midline laparotomy. Good visceral pain coverage too, no morphine required intra-op.

@mamont5943 2 ай бұрын

After an ESPB how long until you can drive?

@nishabindu8290 3 жыл бұрын

Beautiful presentation... Just a question?? Why is that the needle not that clearly visible ??

@SamtaniPradeep Жыл бұрын

Sir can you share some reference articles where 30ml volume spreads to 8 Thoracic levels and 4 Lumbar levels is mentioned?? Thanks in advance Sir

@SamtaniPradeep Жыл бұрын

@@regionalanesthesiology Thank you very much Sir

@charlieclark3029 2 жыл бұрын

Which probe and which machine is that? Specifically which curvilinear probe and which linear probe? Our curvilinear looks nowhere near that clear

@jxij99 10 ай бұрын

Perfect

@regionalanesthesiology 10 ай бұрын

Thanks!! Appreciate you watching!

@dr.shantanumallick1643 10 ай бұрын

Actually this is paravertebral block. because ES muscle is supplied by dorsal rami. How come blocking Dorsal rami you can block the pain from the structures which are supplied by ventral rami. So, anatomically you are definitely blocking both the rami. That's why it's better to say paravertebral block. Better to give epidural to get better effect with less dose. Can you achieve the same effect giving 5ml in ES block which is possible with that less dose in epidural?

@regionalanesthesiology 10 ай бұрын

Thanks for your insightful comments! Yes, agree, one of the proposed mechanisms for how the ESP block works is spread of local anesthetic to the ventral (anterior) side of the transverse process, which is essentially the paravertebral space. Some have called this the "paravertebral by proxy". There are still lots of unanswered questions about volume and dosing. For example, if I put 5 ml in the true paravetebral space, I can definitely expect to get a dense block of that nerve root (both rami). I don't believe 5 mL placed as an ESP block would do that...which is why we use so much volume in ESP blocks. Thanks for watching!