====== 🧠 Erector Spinae Plane (ESP) Block ====== **Overview:** The ESP block is an interfascial regional anesthesia technique that provides thoracic and abdominal analgesia. It has gained popularity due to its ease of use, safety profile, and effectiveness. ---- - The erector spinae muscles lie over the transverse processes of the vertebrae. - The target injection point is **deep to the erector spinae muscle**, just superficial to the **transverse process**. - Common levels: - **T5** for thoracic analgesia - **T7–T9** for abdominal analgesia - **Position**: Sitting, lateral decubitus, or prone. - **Ultrasound**: High-frequency linear probe to visualize: - Skin - Subcutaneous tissue - Erector spinae muscle - Transverse process (hyperechoic line) - **Needle**: In-plane approach toward the transverse process. - **Injection**: 20–30 mL of local anesthetic (e.g., ropivacaine 0.25–0.5%) after hydrodissection confirms correct plane. - Thoracic trauma (e.g. rib fractures) - Video-assisted thoracoscopic surgery (VATS) - Breast surgery - Abdominal surgery (e.g. hernia repair, laparoscopic procedures) - Spine surgery - Chronic thoracoabdominal pain - Easy to perform with ultrasound guidance - Lower risk of complications compared to epidural or paravertebral block - Can be used in anticoagulated patients (relative) - Provides both somatic and visceral analgesia - Block failure - Local anesthetic systemic toxicity (LAST) - Infection or hematoma (rare) - Inadequate spread in some patients ---- 📌 **Tags**: regional anesthesia, ESP block, ultrasound, pain management, interfascial plane