Lumbar erector spinae plane block obtunding knee and ankle reflexes
The erector spinae plane block (ESPB) has recently been described as an effective analgesic strategy for various surgeries at ventral and dorsal parts of body. The block has been utilized for postoperative pain relief in hip surgeries. Cadaveric and clinical studies performed at the lumbar level dep...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Saudi Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.saudija.org/article.asp?issn=1658-354X;year=2021;volume=15;issue=2;spage=222;epage=224;aulast= |
| _version_ | 1818453918927028224 |
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| author | Sandeep Diwan Abhijit Nair |
| author_facet | Sandeep Diwan Abhijit Nair |
| author_sort | Sandeep Diwan |
| collection | DOAJ |
| description | The erector spinae plane block (ESPB) has recently been described as an effective analgesic strategy for various surgeries at ventral and dorsal parts of body. The block has been utilized for postoperative pain relief in hip surgeries. Cadaveric and clinical studies performed at the lumbar level depict a dorsal spread and minimal ventral spread in the lumbar plexus. So far to our knowledge there is one case report which has described reduced quadriceps strength in a parturient after caesarean section. We report two patients who presented with absent knee reflexes (decreased quadriceps strength) and one patient with absent ankle reflex (foot drop) following continuous ESPB at the level of L3. The initial bolus was with 30 ml of 0.1% bupivacaine followed by a continuous infusion of 0.1% ropivacaine at 8ml/hour. The loss of knee reflexes in two patients and diminished reflexes in one patient suggested spread of local anaesthetic (LA) to the lumbosacral plexus. The LA infusion were stopped in all 3 patients. The average duration of motor block was 18 hours. These complications should be considered if early ambulation is mandatory for patients. |
| first_indexed | 2024-12-14T21:46:38Z |
| format | Article |
| id | doaj.art-465ec88ca8c94decac4b1de26500f00c |
| institution | Directory Open Access Journal |
| issn | 1658-354X |
| language | English |
| last_indexed | 2024-12-14T21:46:38Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Anaesthesia |
| spelling | doaj.art-465ec88ca8c94decac4b1de26500f00c2022-12-21T22:46:20ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X2021-01-0115222222410.4103/sja.SJA_79_20Lumbar erector spinae plane block obtunding knee and ankle reflexesSandeep DiwanAbhijit NairThe erector spinae plane block (ESPB) has recently been described as an effective analgesic strategy for various surgeries at ventral and dorsal parts of body. The block has been utilized for postoperative pain relief in hip surgeries. Cadaveric and clinical studies performed at the lumbar level depict a dorsal spread and minimal ventral spread in the lumbar plexus. So far to our knowledge there is one case report which has described reduced quadriceps strength in a parturient after caesarean section. We report two patients who presented with absent knee reflexes (decreased quadriceps strength) and one patient with absent ankle reflex (foot drop) following continuous ESPB at the level of L3. The initial bolus was with 30 ml of 0.1% bupivacaine followed by a continuous infusion of 0.1% ropivacaine at 8ml/hour. The loss of knee reflexes in two patients and diminished reflexes in one patient suggested spread of local anaesthetic (LA) to the lumbosacral plexus. The LA infusion were stopped in all 3 patients. The average duration of motor block was 18 hours. These complications should be considered if early ambulation is mandatory for patients.http://www.saudija.org/article.asp?issn=1658-354X;year=2021;volume=15;issue=2;spage=222;epage=224;aulast=ambulatory surgery; complications; erector spinae; regional anaesthesia |
| spellingShingle | Sandeep Diwan Abhijit Nair Lumbar erector spinae plane block obtunding knee and ankle reflexes Saudi Journal of Anaesthesia ambulatory surgery; complications; erector spinae; regional anaesthesia |
| title | Lumbar erector spinae plane block obtunding knee and ankle reflexes |
| title_full | Lumbar erector spinae plane block obtunding knee and ankle reflexes |
| title_fullStr | Lumbar erector spinae plane block obtunding knee and ankle reflexes |
| title_full_unstemmed | Lumbar erector spinae plane block obtunding knee and ankle reflexes |
| title_short | Lumbar erector spinae plane block obtunding knee and ankle reflexes |
| title_sort | lumbar erector spinae plane block obtunding knee and ankle reflexes |
| topic | ambulatory surgery; complications; erector spinae; regional anaesthesia |
| url | http://www.saudija.org/article.asp?issn=1658-354X;year=2021;volume=15;issue=2;spage=222;epage=224;aulast= |
| work_keys_str_mv | AT sandeepdiwan lumbarerectorspinaeplaneblockobtundingkneeandanklereflexes AT abhijitnair lumbarerectorspinaeplaneblockobtundingkneeandanklereflexes |