A Novel Technique to Reduce Reliance on Opioids for Analgesia from Acute Appendicitis: The Ultrasound-guided Erector Spinae Plane Block
Single injection, ultrasound-guided nerve blocks have drastically changed the multimodal approach to pain management of the acutely injured patient in the emergency department (ED). Ultrasound-guided femoral nerve blocks in the ED have become standard aspects of multiple, hospital system pain manage...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2019-08-01
|
| Series: | Clinical Practice and Cases in Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/81p0c0sq |
| _version_ | 1818454508292800512 |
|---|---|
| author | Daniel Mantuani Josh Luftig Andrew Herring Andrea Dreyfuss Arun Nagdev |
| author_facet | Daniel Mantuani Josh Luftig Andrew Herring Andrea Dreyfuss Arun Nagdev |
| author_sort | Daniel Mantuani |
| collection | DOAJ |
| description | Single injection, ultrasound-guided nerve blocks have drastically changed the multimodal approach to pain management of the acutely injured patient in the emergency department (ED). Ultrasound-guided femoral nerve blocks in the ED have become standard aspects of multiple, hospital system pain management protocols, with early evidence demonstrating improved patient outcomes. Developing a multimodal pain management strategy can improve analgesia while reducing reliance on opioids in this era of opioid addiction. 1 The single injection, ultrasound-guided erector spinae plane (ESP) block is a technique safely used for pain control for rib fractures that can be easily performed at the bedside and integrated into optimal emergency care. A more inferiorly located ultrasound-guided ESP block has been recently described in the anesthesia literature for perioperative pain control for various abdominal surgeries but has not yet been described for patients with acute appendicitis. Here we describe a single injection, lower ESP block performed by emergency physicians that successfully alleviated pain from acute appendicitis in an ED patient awaiting definitive surgical treatment. Along with allowing clinicians to actively manage pain without reliance on opioids, this novel ED technique may improve patient care outcomes. |
| first_indexed | 2024-12-14T21:56:00Z |
| format | Article |
| id | doaj.art-ac203bdeffd944d3aa0d1be7d749d05b |
| institution | Directory Open Access Journal |
| issn | 2474-252X |
| language | English |
| last_indexed | 2024-12-14T21:56:00Z |
| publishDate | 2019-08-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Clinical Practice and Cases in Emergency Medicine |
| spelling | doaj.art-ac203bdeffd944d3aa0d1be7d749d05b2022-12-21T22:46:07ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2019-08-013310.5811/cpcem.2019.4.42117cpcem-3-248A Novel Technique to Reduce Reliance on Opioids for Analgesia from Acute Appendicitis: The Ultrasound-guided Erector Spinae Plane BlockDaniel MantuaniJosh LuftigAndrew HerringAndrea DreyfussArun NagdevSingle injection, ultrasound-guided nerve blocks have drastically changed the multimodal approach to pain management of the acutely injured patient in the emergency department (ED). Ultrasound-guided femoral nerve blocks in the ED have become standard aspects of multiple, hospital system pain management protocols, with early evidence demonstrating improved patient outcomes. Developing a multimodal pain management strategy can improve analgesia while reducing reliance on opioids in this era of opioid addiction. 1 The single injection, ultrasound-guided erector spinae plane (ESP) block is a technique safely used for pain control for rib fractures that can be easily performed at the bedside and integrated into optimal emergency care. A more inferiorly located ultrasound-guided ESP block has been recently described in the anesthesia literature for perioperative pain control for various abdominal surgeries but has not yet been described for patients with acute appendicitis. Here we describe a single injection, lower ESP block performed by emergency physicians that successfully alleviated pain from acute appendicitis in an ED patient awaiting definitive surgical treatment. Along with allowing clinicians to actively manage pain without reliance on opioids, this novel ED technique may improve patient care outcomes.https://escholarship.org/uc/item/81p0c0sq |
| spellingShingle | Daniel Mantuani Josh Luftig Andrew Herring Andrea Dreyfuss Arun Nagdev A Novel Technique to Reduce Reliance on Opioids for Analgesia from Acute Appendicitis: The Ultrasound-guided Erector Spinae Plane Block Clinical Practice and Cases in Emergency Medicine |
| title | A Novel Technique to Reduce Reliance on Opioids for Analgesia from Acute Appendicitis: The Ultrasound-guided Erector Spinae Plane Block |
| title_full | A Novel Technique to Reduce Reliance on Opioids for Analgesia from Acute Appendicitis: The Ultrasound-guided Erector Spinae Plane Block |
| title_fullStr | A Novel Technique to Reduce Reliance on Opioids for Analgesia from Acute Appendicitis: The Ultrasound-guided Erector Spinae Plane Block |
| title_full_unstemmed | A Novel Technique to Reduce Reliance on Opioids for Analgesia from Acute Appendicitis: The Ultrasound-guided Erector Spinae Plane Block |
| title_short | A Novel Technique to Reduce Reliance on Opioids for Analgesia from Acute Appendicitis: The Ultrasound-guided Erector Spinae Plane Block |
| title_sort | novel technique to reduce reliance on opioids for analgesia from acute appendicitis the ultrasound guided erector spinae plane block |
| url | https://escholarship.org/uc/item/81p0c0sq |
| work_keys_str_mv | AT danielmantuani anoveltechniquetoreducerelianceonopioidsforanalgesiafromacuteappendicitistheultrasoundguidederectorspinaeplaneblock AT joshluftig anoveltechniquetoreducerelianceonopioidsforanalgesiafromacuteappendicitistheultrasoundguidederectorspinaeplaneblock AT andrewherring anoveltechniquetoreducerelianceonopioidsforanalgesiafromacuteappendicitistheultrasoundguidederectorspinaeplaneblock AT andreadreyfuss anoveltechniquetoreducerelianceonopioidsforanalgesiafromacuteappendicitistheultrasoundguidederectorspinaeplaneblock AT arunnagdev anoveltechniquetoreducerelianceonopioidsforanalgesiafromacuteappendicitistheultrasoundguidederectorspinaeplaneblock AT danielmantuani noveltechniquetoreducerelianceonopioidsforanalgesiafromacuteappendicitistheultrasoundguidederectorspinaeplaneblock AT joshluftig noveltechniquetoreducerelianceonopioidsforanalgesiafromacuteappendicitistheultrasoundguidederectorspinaeplaneblock AT andrewherring noveltechniquetoreducerelianceonopioidsforanalgesiafromacuteappendicitistheultrasoundguidederectorspinaeplaneblock AT andreadreyfuss noveltechniquetoreducerelianceonopioidsforanalgesiafromacuteappendicitistheultrasoundguidederectorspinaeplaneblock AT arunnagdev noveltechniquetoreducerelianceonopioidsforanalgesiafromacuteappendicitistheultrasoundguidederectorspinaeplaneblock |