Continuous erector spinae plane block for analgesia of sternum closure using a latissimus dorsi muscle flap for mediastinitis after coronary artery bypass grafting: a case report

• Main Authors: Yu Yamane, Masayuki Kosaka, Haruki Akiizumi, Mitsuo Kuroda
• Format: Article
• Language: English
• Published: SpringerOpen 2020-08-01
• Series: JA Clinical Reports
• Subjects: Continuous erector spinae plane block; Latissimus dorsi muscle flap; Coronary artery bypass grafting; Antithrombotic drug
• Online Access: http://link.springer.com/article/10.1186/s40981-020-00370-3

Abstract Background Erector spinae plane block (ESPB) is useful for providing analgesia after thoracic surgery. Previous reports show that ESPB is safely performed in patients receiving antithrombotic drugs. We effectively performed continuous ESPB in a patient receiving aspirin after coronary artery bypass grafting. Case presentation A 62-year-old man with mediastinitis was scheduled for sternum closure using a latissimus dorsi muscle flap. He had gone coronary artery bypass grafting and was taking aspirin. After induction of general anesthesia and tracheal intubation, a catheter was inserted for ESPB from the T6 level under ultrasound monitoring and infusion of ropivacaine was started. Tracheal tube was removed in the operating room, cold sense was absent between T2–8, and analgesia was between T3–T8 after uneventful surgery. There were no complications associated with ESPB postoperatively. Conclusion Continuous ESPB was a safe and useful analgesic method in a case undergoing sternum closure using a latissimus dorsi muscle flap.