Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient

Matheus de Castro Abi-Ramia Chimelli; Amanda Caroline Figueiredo Gomes Andrade; Marcelo Grisólia Gonçalo; Clarissa Mayara de Sales Guimarães; Carlos Frederico Panisset Lanhas La Cava; Carlos Darcy Alves Bersot

doi:doi:10.11648/j.ass.20190702.12

Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient

Matheus de Castro Abi-Ramia Chimelli, Amanda Caroline Figueiredo Gomes Andrade, Marcelo Grisólia Gonçalo, Clarissa Mayara de Sales Guimarães, Carlos Frederico Panisset Lanhas La Cava, Carlos Darcy Alves Bersot

Published in Advances in Surgical Sciences (Volume 7, Issue 2)

Received: 9 November 2019 Accepted: 17 December 2019 Published: 30 December 2019

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Abstract

Neurofibromatosis remains a challenge for the anesthesiologist as it brings issues especially regarding safety of anesthetic management such as airway management and neuraxial anesthesia. We report a case of a 60 year-old woman with controlled clinical comorbidities and neurofibromatosis, admitted for an open thoracotomy for excision of a growing pulmonary lesion, highly suspicious for malignancy. She had cutaneous tumors covering the majority of her skin. No neuroimage was available to exclude neuraxial or intracranial tumors, ensuring the safety for neuraxial anesthesia, therefore a combined technique was proposed with general anesthesia and a continuous erector spinae plane (ESP) block for anesthesia and analgesia. Surgery occurred successfully and there was no need to supplement or alter the initially planned anesthetic technique. Patient referred pain score ranging from 0-1 in rest and motion postoperative and required no complementary opioid for pain control. Infusion in the ESP catheter was maintained for 48h, after which it was removed and patient discharged without further complications or pain.

Published in	Advances in Surgical Sciences (Volume 7, Issue 2)
DOI	10.11648/j.ass.20190702.12
Page(s)	35-37
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

ESP Block Technique, Thoracotomy, Neurofibromatosis Patient, Anesthesia

References

[1]	Hirsch NP, Murphy A, Radcliffe JJ. Neurofibromatosis: clinical presentations and anaesthetic implications. Br J Anaesth. 2001; 86: 555-564.
[2]	Crowe FW, Schull WJ, Neel JV. A Clinical, Pathological, and Genetic Study of Multiple Neurofibromatosis. Springfield, IL: Charles C. Thomas, 1956.
[3]	Fox CJ, Tomaijian S, Kaye AJ, et al. Perioperative management of neurofibromatosis type 1. Ochsner J 2012; 12: 111-121.
[4]	McSwain JR, Doty JW, Wilson SW. Regional anesthesia in patients with pre-existing neurologic disease. Curr Opin Anesthesiol 2014; 27: 538-543.
[5]	Forero M, Adhikary SD, Lopez H. The Erector Spinae Plane Block: A Novel Analgesic Technique in Thoracic Neuropathic Pain. Reg Anesth Pain Med 2016; 41: 621-627.
[6]	Chin KJ, Adhikary S, Sarwani N, et al. The analgesic efficacy of pre-operative bilateral erector spinae plane (ESP) blocks in patients having ventral hernia repair. Anaesthesia 2017; 72: 1-8.
[7]	Chin KJ, Malhas L, Perlas A. The Erector Spinae Plane Block Provides Visceral Abdominal Analgesia in Bariatric Surgery. Reg Anesth Pain Med 2017; 42: 372-376.
[8]	Freise H, Van Aken HK. Risks and Benefits of thoracic epidural anaesthesia. British Journal of Anaesthesia. 2011; 107 (6): 859-868.
[9]	Block BM, Liu SS, Rowlingson AJ, et al. Efficacy of Postoperative Epidural Analgesia: A Metanalysis. JAMA 2003; 290: 2455-2463.
[10]	Williams UU, Zavala AM, Van Meter A, et al. Unanticipated Compression of the Trachea in a 5-month-old Undergoing an MRI for Evaluation of Neurofibromatosis. A&A Case Reports 2017; 8: 1-3.
[11]	Spiegel JE, Hapgood A, Hess PE. Epidural anesthesia in a parturient with neurofibromatosis type 2 undergoing cesarean section. International Journal of Obstetric Anesthesia. 2005; 14: 336-339.
[12]	Esler MD, Durbridge J, Kirby S. Epidural haematoma after dural puncture in a parturient with neurofibromatosis. Br J Anaesth 2001; 87: 932-934.

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APA Style

Matheus de Castro Abi-Ramia Chimelli, Amanda Caroline Figueiredo Gomes Andrade, Marcelo Grisólia Gonçalo, Clarissa Mayara de Sales Guimarães, Carlos Frederico Panisset Lanhas La Cava, et al. (2019). Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient. Advances in Surgical Sciences, 7(2), 35-37. https://doi.org/10.11648/j.ass.20190702.12

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ACS Style

Matheus de Castro Abi-Ramia Chimelli; Amanda Caroline Figueiredo Gomes Andrade; Marcelo Grisólia Gonçalo; Clarissa Mayara de Sales Guimarães; Carlos Frederico Panisset Lanhas La Cava, et al. Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient. Adv. Surg. Sci. 2019, 7(2), 35-37. doi: 10.11648/j.ass.20190702.12

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AMA Style

Matheus de Castro Abi-Ramia Chimelli, Amanda Caroline Figueiredo Gomes Andrade, Marcelo Grisólia Gonçalo, Clarissa Mayara de Sales Guimarães, Carlos Frederico Panisset Lanhas La Cava, et al. Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient. Adv Surg Sci. 2019;7(2):35-37. doi: 10.11648/j.ass.20190702.12

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@article{10.11648/j.ass.20190702.12,
  author = {Matheus de Castro Abi-Ramia Chimelli and Amanda Caroline Figueiredo Gomes Andrade and Marcelo Grisólia Gonçalo and Clarissa Mayara de Sales Guimarães and Carlos Frederico Panisset Lanhas La Cava and Carlos Darcy Alves Bersot},
  title = {Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient},
  journal = {Advances in Surgical Sciences},
  volume = {7},
  number = {2},
  pages = {35-37},
  doi = {10.11648/j.ass.20190702.12},
  url = {https://doi.org/10.11648/j.ass.20190702.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20190702.12},
  abstract = {Neurofibromatosis remains a challenge for the anesthesiologist as it brings issues especially regarding safety of anesthetic management such as airway management and neuraxial anesthesia. We report a case of a 60 year-old woman with controlled clinical comorbidities and neurofibromatosis, admitted for an open thoracotomy for excision of a growing pulmonary lesion, highly suspicious for malignancy. She had cutaneous tumors covering the majority of her skin. No neuroimage was available to exclude neuraxial or intracranial tumors, ensuring the safety for neuraxial anesthesia, therefore a combined technique was proposed with general anesthesia and a continuous erector spinae plane (ESP) block for anesthesia and analgesia. Surgery occurred successfully and there was no need to supplement or alter the initially planned anesthetic technique. Patient referred pain score ranging from 0-1 in rest and motion postoperative and required no complementary opioid for pain control. Infusion in the ESP catheter was maintained for 48h, after which it was removed and patient discharged without further complications or pain.},
 year = {2019}
}

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TY  - JOUR
T1  - Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient
AU  - Matheus de Castro Abi-Ramia Chimelli
AU  - Amanda Caroline Figueiredo Gomes Andrade
AU  - Marcelo Grisólia Gonçalo
AU  - Clarissa Mayara de Sales Guimarães
AU  - Carlos Frederico Panisset Lanhas La Cava
AU  - Carlos Darcy Alves Bersot
Y1  - 2019/12/30
PY  - 2019
N1  - https://doi.org/10.11648/j.ass.20190702.12
DO  - 10.11648/j.ass.20190702.12
T2  - Advances in Surgical Sciences
JF  - Advances in Surgical Sciences
JO  - Advances in Surgical Sciences
SP  - 35
EP  - 37
PB  - Science Publishing Group
SN  - 2376-6182
UR  - https://doi.org/10.11648/j.ass.20190702.12
AB  - Neurofibromatosis remains a challenge for the anesthesiologist as it brings issues especially regarding safety of anesthetic management such as airway management and neuraxial anesthesia. We report a case of a 60 year-old woman with controlled clinical comorbidities and neurofibromatosis, admitted for an open thoracotomy for excision of a growing pulmonary lesion, highly suspicious for malignancy. She had cutaneous tumors covering the majority of her skin. No neuroimage was available to exclude neuraxial or intracranial tumors, ensuring the safety for neuraxial anesthesia, therefore a combined technique was proposed with general anesthesia and a continuous erector spinae plane (ESP) block for anesthesia and analgesia. Surgery occurred successfully and there was no need to supplement or alter the initially planned anesthetic technique. Patient referred pain score ranging from 0-1 in rest and motion postoperative and required no complementary opioid for pain control. Infusion in the ESP catheter was maintained for 48h, after which it was removed and patient discharged without further complications or pain.
VL  - 7
IS  - 2
ER  -

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Author Information

Matheus de Castro Abi-Ramia Chimelli

Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Amanda Caroline Figueiredo Gomes Andrade

Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Marcelo Grisólia Gonçalo
Clarissa Mayara de Sales Guimarães
Carlos Frederico Panisset Lanhas La Cava

Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
Carlos Darcy Alves Bersot

Department of Anesthesiology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil

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APA Style

Matheus de Castro Abi-Ramia Chimelli, Amanda Caroline Figueiredo Gomes Andrade, Marcelo Grisólia Gonçalo, Clarissa Mayara de Sales Guimarães, Carlos Frederico Panisset Lanhas La Cava, et al. (2019). Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient. Advances in Surgical Sciences, 7(2), 35-37. https://doi.org/10.11648/j.ass.20190702.12

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ACS Style

Matheus de Castro Abi-Ramia Chimelli; Amanda Caroline Figueiredo Gomes Andrade; Marcelo Grisólia Gonçalo; Clarissa Mayara de Sales Guimarães; Carlos Frederico Panisset Lanhas La Cava, et al. Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient. Adv. Surg. Sci. 2019, 7(2), 35-37. doi: 10.11648/j.ass.20190702.12

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AMA Style

Matheus de Castro Abi-Ramia Chimelli, Amanda Caroline Figueiredo Gomes Andrade, Marcelo Grisólia Gonçalo, Clarissa Mayara de Sales Guimarães, Carlos Frederico Panisset Lanhas La Cava, et al. Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient. Adv Surg Sci. 2019;7(2):35-37. doi: 10.11648/j.ass.20190702.12

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@article{10.11648/j.ass.20190702.12,
  author = {Matheus de Castro Abi-Ramia Chimelli and Amanda Caroline Figueiredo Gomes Andrade and Marcelo Grisólia Gonçalo and Clarissa Mayara de Sales Guimarães and Carlos Frederico Panisset Lanhas La Cava and Carlos Darcy Alves Bersot},
  title = {Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient},
  journal = {Advances in Surgical Sciences},
  volume = {7},
  number = {2},
  pages = {35-37},
  doi = {10.11648/j.ass.20190702.12},
  url = {https://doi.org/10.11648/j.ass.20190702.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20190702.12},
  abstract = {Neurofibromatosis remains a challenge for the anesthesiologist as it brings issues especially regarding safety of anesthetic management such as airway management and neuraxial anesthesia. We report a case of a 60 year-old woman with controlled clinical comorbidities and neurofibromatosis, admitted for an open thoracotomy for excision of a growing pulmonary lesion, highly suspicious for malignancy. She had cutaneous tumors covering the majority of her skin. No neuroimage was available to exclude neuraxial or intracranial tumors, ensuring the safety for neuraxial anesthesia, therefore a combined technique was proposed with general anesthesia and a continuous erector spinae plane (ESP) block for anesthesia and analgesia. Surgery occurred successfully and there was no need to supplement or alter the initially planned anesthetic technique. Patient referred pain score ranging from 0-1 in rest and motion postoperative and required no complementary opioid for pain control. Infusion in the ESP catheter was maintained for 48h, after which it was removed and patient discharged without further complications or pain.},
 year = {2019}
}

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TY  - JOUR
T1  - Continuous ESP Block Technique for an Open Thoracotomy in Neurofibromatosis Patient
AU  - Matheus de Castro Abi-Ramia Chimelli
AU  - Amanda Caroline Figueiredo Gomes Andrade
AU  - Marcelo Grisólia Gonçalo
AU  - Clarissa Mayara de Sales Guimarães
AU  - Carlos Frederico Panisset Lanhas La Cava
AU  - Carlos Darcy Alves Bersot
Y1  - 2019/12/30
PY  - 2019
N1  - https://doi.org/10.11648/j.ass.20190702.12
DO  - 10.11648/j.ass.20190702.12
T2  - Advances in Surgical Sciences
JF  - Advances in Surgical Sciences
JO  - Advances in Surgical Sciences
SP  - 35
EP  - 37
PB  - Science Publishing Group
SN  - 2376-6182
UR  - https://doi.org/10.11648/j.ass.20190702.12
AB  - Neurofibromatosis remains a challenge for the anesthesiologist as it brings issues especially regarding safety of anesthetic management such as airway management and neuraxial anesthesia. We report a case of a 60 year-old woman with controlled clinical comorbidities and neurofibromatosis, admitted for an open thoracotomy for excision of a growing pulmonary lesion, highly suspicious for malignancy. She had cutaneous tumors covering the majority of her skin. No neuroimage was available to exclude neuraxial or intracranial tumors, ensuring the safety for neuraxial anesthesia, therefore a combined technique was proposed with general anesthesia and a continuous erector spinae plane (ESP) block for anesthesia and analgesia. Surgery occurred successfully and there was no need to supplement or alter the initially planned anesthetic technique. Patient referred pain score ranging from 0-1 in rest and motion postoperative and required no complementary opioid for pain control. Infusion in the ESP catheter was maintained for 48h, after which it was removed and patient discharged without further complications or pain.
VL  - 7
IS  - 2
ER  -

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