Acute pain is a common occurrence on any intensive care unit as a result of trauma and major emergency surgery. In elective cases continuous neuraxial blocks are a cornerstone of multimodal analgesia. In an emergency setting, the issues of consent, coagulopathies and sepsis often preclude the use of such procedures. Additionally, performing neuraxials blocks in patients that are intubated and sedated is challenging. Neurological complications are also difficult to assess. Uncontrolled pain will increase sedation requirements, the likelyhood of respiratory complications and long term morbidity as well as chronic pain. These issues become especially apparent in thoracic trauma and emergency thoracotomy which carry an increased of respiratory failure and persistent pain. We observe promising results with the erector spinae plane block (ESP) which is easy to perform with a steep learning curve.

We present a case of thoracic trauma, in which the ESP has been successfully employed to supplement general anaesthesia and alleviate postoperative pain which resulted in improved respiratory function and mobilisation.

11 / Ultrasound guided erector spinae plane (ESP) block in thoracic trauma