Erector spinae plane block for proximal shoulder surgery: A phrenic nerve sparing block!

Abstract

There are several indications of erector spinae plane block (ESPB) for managing postoperative surgical pain. We investigated the efficacy of ultrasound-guided ESPB at T2-T3 level in five patients undergoing surgery for proximal humerus fracture and found that it provided excellent analgesia in the postoperative period. To investigate the spread of local anaesthetic at this level, we performed contrast-enhanced computed tomography studies, to understand the possible mechanism of action. We believe that ESPB at this level is a good and safe alternative to routinely used brachial plexus blocks, as it not only provides good analgesia but also spares the phrenic nerve.