The erector spinae plane (ESP) block, which is guided by ultrasound, is helpful in thoracoabdominal surgeries for managing postoperative pain. With the increased use of adjuvants in local anaesthetics, the duration of the block can be extended. In this case, tramadol was utilised as an adjuvant to ropivacaine for a single shot bilateral ultrasound guided ESP block to give effective analgesia in a patient who was having surgery for removal of an anterior mediastinal teratoma through a midline sternotomy. A median sternotomy was used to remove a mediastinal teratoma from a 21-year-old female patient. She was put under general anaesthetic using over-the-counter anaesthetics. At the conclusion of surgery, the patient had a bilateral ultrasound guided ESP block with 10 ml of injectable ropivacaine 0.2 percent and 50 mg tramadol at T5 level on each side. Visual analogue scores (VAS) were in the range of 2-3 for the first 24 hours, then in the range of 1 for the next 24 hours. The patient was pain-free for the first 48 hours after surgery and did not require any medications. The use of an ultrasound-guided ESP block for severe sternotomy postoperative pain can be very beneficial. Tramadol can also be taken as an adjuvant to keep the block going for up to 48 hours.
Author(S) Details
Sofia Jaswal
Department of Anaesthesia, Critical care and Pain, Homi Bhabha Cancer Hospital and Research Cente, Punjab, India
Rashi Sarna
Department of Anaesthesia, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Richa Saroa
Department of Anaesthesia, Government Medical College & Hospital, Chandigarh, India.
Sanjeev Palta
Department of Anaesthesia, Government Medical College & Hospital, Chandigarh, India.
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