Erector spinae plane block for rescue analgesia following caesarean delivery.

Abstract

dear Editor, Pain after caesarean section is still a common and important source of patient dissatisfaction in many obstetric centres. With intrathecal morphine combined with multimodal analgesia, approximately 5–10% of patients experience severe breakthrough pain after caesarean delivery that is difficult to manage [1]. Planned erector spinae plane (EsP) block can result in excellent postoperative analgesia associated with high patient satisfaction after caesarean delivery [2, 3]. However, the role of this block for rescue analgesia following caesarean section has never been described. We present a case in which bilateral EsP block was used as rescue analgesia in a woman who had severe postoperative pain following elective caesarean delivery under spinal anaesthesia combined with multimodal analgesia. the patient described in this case gave written consent for publication of this observation. A 23-year-old primigravida woman, body mass index of 32 kg m-2, underwent an uncomplicated caesarean delivery under spinal anaesthesia which consisted of 0.5% hyperbaric bupivacaine 10 mg, and morphine 200 μg. surgery was uncomplicated and lasted 55 min. she received paracetamol 1 g and ketoprofen 100 mg at the end of the surgery. in the Post-Anaesthesia Care Unit (PACU), when her spinal anaesthesia block had resolved, the patient experienced pain rated 9/10 on the numerical rating scale (Nrs) over the surgical incision. she received fentanyl 50 μg and morphine 5 mg intravenously, which resulted in DOI: https://doi.org/10.5114/ait.2021.103514