New method of performing erector spine plane block for treatment of pain syndrome
Keywords:erector spinae plane block, osteochondrosis, local anesthetics, pain syndrome, von Frey monofilaments
Background. Osteochondrosis is one of the most common causes of pain in back and extremities. Treatment methods range from therapeutic exercises and massage to complex transpedicular spine fixations with decompression of the spinal cord and its roots. In the most difficult cases, despite adequate surgery, pain might return with no less intensity. The purpose was to describe a clinical case of pain treatment in a patient with generalized osteochondrosis accompanied by a postoperative surgery muscular-tonic syndrome. Results. Chronic pain could not be controlled with nonsteroidal anti-inflammatory drugs and pregabalin, however, it was effectively relieved using the technique of regional anesthesia, erector spinae plane block. The main difficulty and danger of the blockade was that if the patient already had metal structure in the body this might have changed anatomical landmarks, and metal itself scattered ultrasound rays in such way that the picture on ultrasound monitor was not good enough to safely and effectively perform regional anesthesia. Therefore, erector spinae plane block was performed under the control of digital radiography. Conclusions. Erector spine plane block can be used to treat severe pain regardless of its etiology. The use of digital radiography to perform blockade can be an alternative technique if ultrasound imaging is technically difficult or impossible due to different reasons.
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