Unpredictable Injectate Spread of the Erector Spinae Plane Block in Human Cadavers

What is it about?

The erector spinae plane block (ESPB) is an anesthetic method whereby local anesthetics are injected beneath the erector spinae muscles (ESM) to achieve thoracic or abdominal analgesia. In 11 fresh frozen cadavers, we evaluated the spread of methylene blue dye following a bilateral ultrasound-guided ESPB at two thoracic levels. The dye spread variably and extensively deep to the ESM fascia with involvement of the spinal rami and epidural space in 1/11 cadavers when injected at Th8 and in 4/11 cadavers at Th2 with crossover to the contralateral side of the spine at this level.

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