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LETTERS TO EDITOR
Year : 2020  |  Volume : 14  |  Issue : 2  |  Page : 274

Re: Erector spinae plane block: Anatomical landmark-guided technique


Department of Anesthesiology and Intensive Care, Military Hospital Mohammed V, Rabat, Morocco

Correspondence Address:
Dr. Abdelghafour Elkoundi
Department of Anesthesiology and Intensive Care, Military Hospital Mohammed V, FAR Avenue - 10045, Rabat
Morocco
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sja.SJA_19_20

Rights and Permissions
Date of Submission06-Jan-2020
Date of Acceptance07-Jan-2020
Date of Web Publication5-Mar-2020
 


How to cite this article:
Elkoundi A, Bensghir M. Re: Erector spinae plane block: Anatomical landmark-guided technique. Saudi J Anaesth 2020;14:274

How to cite this URL:
Elkoundi A, Bensghir M. Re: Erector spinae plane block: Anatomical landmark-guided technique. Saudi J Anaesth [serial online] 2020 [cited 2020 Mar 30];14:274. Available from: http://www.saudija.org/text.asp?2020/14/2/274/280061



Sir,

We read with interest the recent article by Vadera and colleagues “Erector spinae plane block: Anatomical landmark- guided technique”.[1] Authors presented a novel technique of erector spinae plane (ESP) block using anatomical landmarks.

We have described a more inferiorly located anatomical landmark-guided ESP block prior to Vadera et al. observation, for perioperative pain control in a patient with severe aortic stenosis undergoing an emergency abdominal surgery.[2] Similarly, to Vadera et al. technique, ESP block was performed in sitting position using the spinous process of the 10th thoracic vertebra as a reper. An ipsilateral point to the side to be operated was then marked 3 cm lateral from the cephalic edge of the spinous process.

As a guard, the forefinger was placed at the 35 mm depth mark on the needle to be advanced. Contact with the transverse process was noted at 3 cm depth. Unlike Vadera et al. observation, ultrasound was not used to confirm the spread of local anesthetics due to its unavailability but the adequacy of blockade was assessed clinically using pinprick test.

Although ESP block performed using anatomical landmarks can provide adequate anesthesia, for safety purpose we suggest using it in lower levels and only as an alternative to ultrasound guided technique in high-risk patients keeping in mind the benefit-risk balance.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Vadera HK, Mistry T. Erector spinae plane block: Anatomical landmark-guided technique. Saudi J Anaesth 2019;13:268-9.  Back to cited text no. 1
[PUBMED]  [Full text]  
2.
Elkoundi A, Chouikh C, Baite A, Bensghir M, Bakkali H, Lalaoui SJ. Successful erector spinae plane block without ultrasound guidance in a severely cardiovascular compromised patient. J Clin Anesth 2019;53:50.  Back to cited text no. 2
    




 

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