Erector spinae plane block for multimodal analgesia after wide midline laparotomy: A case report

We report the case of a 35-year-old female patient who underwent excision of a larger ovarian mass via laparotomy with a wide, midline incision from the xiphoid process to the pubic tubercle. Diagnoses: They were diagnosed with mucinous cystadenoma originated from the right ovary and fallopian tube, and a right oophorectomy and salpingectomy were performed. Interventions: The ESPB was performed for postoperative pain control at the level of the T8 transverse process. Postoperative multimodal analgesia was provided according to the acute pain service protocol of our hospital. The patient was prescribed oral acetaminophen 175 mg every 6 hours and intravenous patient-controlled analgesia (PCA) with fentanyl 7 μg/mL. A 1:1 mixture of 0.75% ropivacaine (20 mL) and saline (20 mL) with epinephrine (1: 200,000) was manually injected through the indwelling catheter every 8 hours (20 mL per side). Outcomes: The first demand dose of fentanyl was administered at 9 hours and 39 minutes after the surgery. There were no reported resting pain scores>4, nor were any rescue analgesics needed during the first 5 postoperative days. Lessons: The ESPB provided highly effective analgesia as a part of multimodal analgesia after laparotomy with a wide midline incision.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research