Neurolytic Erector Spinae Plane Block for Long-Term Oncologic Pain Control: A Report of Two Cases

Jose Correa; Henry Cortes; Patricia Abella; Alberto Quevedo; Olga Correa

doi:doi:10.11648/j.ijacm.20200802.12

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Neurolytic Erector Spinae Plane Block for Long-Term Oncologic Pain Control: A Report of Two Cases

Jose Correa, Henry Cortes, Patricia Abella, Alberto Quevedo, Olga Correa

Published in International Journal of Anesthesia and Clinical Medicine (Volume 8, Issue 2)

Received: 25 July 2020 Accepted: 7 August 2020 Published: 13 August 2020

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Abstract

Background: The erector spinae plane block (ESPB), a novel interfascial plane block initially intended for the management of severe thoracic neuropathic pain by Forero et al, is currently used for many other peri- and post-operative procedures due to its simplicity and safety. Recent numerous studies have demonstrated the effectiveness of ESP blocks in acute pain management, using local anesthetics for their realization, but the true mechanism of action of this block has not yet been determined due to a paucity of evidence of the technique, so the role of ESPB in chronic pain management is limited. Even more, there are no studies using neurolytic techniques in the ESPB. Method: We describe the successful application of the neurolytic substance phenol in 2 female patients with severe pain due to breast cancer where the previous management of the analgesic medications, did not achieved an adequate pain control. Result: The neurolytic-ESPB produced an extensive multidermatomal sensory block, allowing the reduce of the previous total oral opioid requirement for prolonged periods of time after the neurolytic procedure, and reducing, in consequent, the related side effects, improving the quality of life of our patients. Conclusion: The true mechanism of ESPB has not yet been determined, and there is a paucity of evidence of its role in the management of chronic pain with this technique. This balance between effectiveness and safety in all areas of chronic pain, mainly with patients with refractive cancer-pain, where multimodal techniques are chosen, must follow the criteria of evidence-based medicine.

Published in	International Journal of Anesthesia and Clinical Medicine (Volume 8, Issue 2)
DOI	10.11648/j.ijacm.20200802.12
Page(s)	37-41
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), 2020. Published by Science Publishing Group

Keywords

Erector Spinae Plane Block, Chronic Cancer Pain, Interventional Nerve Block Procedures, Neurolytic Block

References

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APA Style

Jose Correa, Henry Cortes, Patricia Abella, Alberto Quevedo, Olga Correa. (2020). Neurolytic Erector Spinae Plane Block for Long-Term Oncologic Pain Control: A Report of Two Cases. International Journal of Anesthesia and Clinical Medicine, 8(2), 37-41. https://doi.org/10.11648/j.ijacm.20200802.12

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ACS Style

Jose Correa; Henry Cortes; Patricia Abella; Alberto Quevedo; Olga Correa. Neurolytic Erector Spinae Plane Block for Long-Term Oncologic Pain Control: A Report of Two Cases. Int. J. Anesth. Clin. Med. 2020, 8(2), 37-41. doi: 10.11648/j.ijacm.20200802.12

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AMA Style

Jose Correa, Henry Cortes, Patricia Abella, Alberto Quevedo, Olga Correa. Neurolytic Erector Spinae Plane Block for Long-Term Oncologic Pain Control: A Report of Two Cases. Int J Anesth Clin Med. 2020;8(2):37-41. doi: 10.11648/j.ijacm.20200802.12

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@article{10.11648/j.ijacm.20200802.12,
  author = {Jose Correa and Henry Cortes and Patricia Abella and Alberto Quevedo and Olga Correa},
  title = {Neurolytic Erector Spinae Plane Block for Long-Term Oncologic Pain Control: A Report of Two Cases},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {8},
  number = {2},
  pages = {37-41},
  doi = {10.11648/j.ijacm.20200802.12},
  url = {https://doi.org/10.11648/j.ijacm.20200802.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20200802.12},
  abstract = {Background: The erector spinae plane block (ESPB), a novel interfascial plane block initially intended for the management of severe thoracic neuropathic pain by Forero et al, is currently used for many other peri- and post-operative procedures due to its simplicity and safety. Recent numerous studies have demonstrated the effectiveness of ESP blocks in acute pain management, using local anesthetics for their realization, but the true mechanism of action of this block has not yet been determined due to a paucity of evidence of the technique, so the role of ESPB in chronic pain management is limited. Even more, there are no studies using neurolytic techniques in the ESPB. Method: We describe the successful application of the neurolytic substance phenol in 2 female patients with severe pain due to breast cancer where the previous management of the analgesic medications, did not achieved an adequate pain control. Result: The neurolytic-ESPB produced an extensive multidermatomal sensory block, allowing the reduce of the previous total oral opioid requirement for prolonged periods of time after the neurolytic procedure, and reducing, in consequent, the related side effects, improving the quality of life of our patients. Conclusion: The true mechanism of ESPB has not yet been determined, and there is a paucity of evidence of its role in the management of chronic pain with this technique. This balance between effectiveness and safety in all areas of chronic pain, mainly with patients with refractive cancer-pain, where multimodal techniques are chosen, must follow the criteria of evidence-based medicine.},
 year = {2020}
}

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TY  - JOUR
T1  - Neurolytic Erector Spinae Plane Block for Long-Term Oncologic Pain Control: A Report of Two Cases
AU  - Jose Correa
AU  - Henry Cortes
AU  - Patricia Abella
AU  - Alberto Quevedo
AU  - Olga Correa
Y1  - 2020/08/13
PY  - 2020
N1  - https://doi.org/10.11648/j.ijacm.20200802.12
DO  - 10.11648/j.ijacm.20200802.12
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 37
EP  - 41
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20200802.12
AB  - Background: The erector spinae plane block (ESPB), a novel interfascial plane block initially intended for the management of severe thoracic neuropathic pain by Forero et al, is currently used for many other peri- and post-operative procedures due to its simplicity and safety. Recent numerous studies have demonstrated the effectiveness of ESP blocks in acute pain management, using local anesthetics for their realization, but the true mechanism of action of this block has not yet been determined due to a paucity of evidence of the technique, so the role of ESPB in chronic pain management is limited. Even more, there are no studies using neurolytic techniques in the ESPB. Method: We describe the successful application of the neurolytic substance phenol in 2 female patients with severe pain due to breast cancer where the previous management of the analgesic medications, did not achieved an adequate pain control. Result: The neurolytic-ESPB produced an extensive multidermatomal sensory block, allowing the reduce of the previous total oral opioid requirement for prolonged periods of time after the neurolytic procedure, and reducing, in consequent, the related side effects, improving the quality of life of our patients. Conclusion: The true mechanism of ESPB has not yet been determined, and there is a paucity of evidence of its role in the management of chronic pain with this technique. This balance between effectiveness and safety in all areas of chronic pain, mainly with patients with refractive cancer-pain, where multimodal techniques are chosen, must follow the criteria of evidence-based medicine.
VL  - 8
IS  - 2
ER  -

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Author Information

Jose Correa

Department of Anesthesia, Fundación Universitaria JN Corpas, Bogotá, Colombia
Henry Cortes

Department of Anesthesia, Fundación Universitaria JN Corpas, Bogotá, Colombia
Patricia Abella

Department of Anesthesia, Fundación Universitaria JN Corpas, Bogotá, Colombia
Alberto Quevedo

Department of Anesthesia, Hospital Universitario Virgen de Las Nieves, Granada, Spain
Olga Correa

RN CMSRN, Baptist Health South Florida, Miami, USA

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APA Style

Jose Correa, Henry Cortes, Patricia Abella, Alberto Quevedo, Olga Correa. (2020). Neurolytic Erector Spinae Plane Block for Long-Term Oncologic Pain Control: A Report of Two Cases. International Journal of Anesthesia and Clinical Medicine, 8(2), 37-41. https://doi.org/10.11648/j.ijacm.20200802.12

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ACS Style

Jose Correa; Henry Cortes; Patricia Abella; Alberto Quevedo; Olga Correa. Neurolytic Erector Spinae Plane Block for Long-Term Oncologic Pain Control: A Report of Two Cases. Int. J. Anesth. Clin. Med. 2020, 8(2), 37-41. doi: 10.11648/j.ijacm.20200802.12

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AMA Style

Jose Correa, Henry Cortes, Patricia Abella, Alberto Quevedo, Olga Correa. Neurolytic Erector Spinae Plane Block for Long-Term Oncologic Pain Control: A Report of Two Cases. Int J Anesth Clin Med. 2020;8(2):37-41. doi: 10.11648/j.ijacm.20200802.12

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@article{10.11648/j.ijacm.20200802.12,
  author = {Jose Correa and Henry Cortes and Patricia Abella and Alberto Quevedo and Olga Correa},
  title = {Neurolytic Erector Spinae Plane Block for Long-Term Oncologic Pain Control: A Report of Two Cases},
  journal = {International Journal of Anesthesia and Clinical Medicine},
  volume = {8},
  number = {2},
  pages = {37-41},
  doi = {10.11648/j.ijacm.20200802.12},
  url = {https://doi.org/10.11648/j.ijacm.20200802.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijacm.20200802.12},
  abstract = {Background: The erector spinae plane block (ESPB), a novel interfascial plane block initially intended for the management of severe thoracic neuropathic pain by Forero et al, is currently used for many other peri- and post-operative procedures due to its simplicity and safety. Recent numerous studies have demonstrated the effectiveness of ESP blocks in acute pain management, using local anesthetics for their realization, but the true mechanism of action of this block has not yet been determined due to a paucity of evidence of the technique, so the role of ESPB in chronic pain management is limited. Even more, there are no studies using neurolytic techniques in the ESPB. Method: We describe the successful application of the neurolytic substance phenol in 2 female patients with severe pain due to breast cancer where the previous management of the analgesic medications, did not achieved an adequate pain control. Result: The neurolytic-ESPB produced an extensive multidermatomal sensory block, allowing the reduce of the previous total oral opioid requirement for prolonged periods of time after the neurolytic procedure, and reducing, in consequent, the related side effects, improving the quality of life of our patients. Conclusion: The true mechanism of ESPB has not yet been determined, and there is a paucity of evidence of its role in the management of chronic pain with this technique. This balance between effectiveness and safety in all areas of chronic pain, mainly with patients with refractive cancer-pain, where multimodal techniques are chosen, must follow the criteria of evidence-based medicine.},
 year = {2020}
}

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TY  - JOUR
T1  - Neurolytic Erector Spinae Plane Block for Long-Term Oncologic Pain Control: A Report of Two Cases
AU  - Jose Correa
AU  - Henry Cortes
AU  - Patricia Abella
AU  - Alberto Quevedo
AU  - Olga Correa
Y1  - 2020/08/13
PY  - 2020
N1  - https://doi.org/10.11648/j.ijacm.20200802.12
DO  - 10.11648/j.ijacm.20200802.12
T2  - International Journal of Anesthesia and Clinical Medicine
JF  - International Journal of Anesthesia and Clinical Medicine
JO  - International Journal of Anesthesia and Clinical Medicine
SP  - 37
EP  - 41
PB  - Science Publishing Group
SN  - 2997-2698
UR  - https://doi.org/10.11648/j.ijacm.20200802.12
AB  - Background: The erector spinae plane block (ESPB), a novel interfascial plane block initially intended for the management of severe thoracic neuropathic pain by Forero et al, is currently used for many other peri- and post-operative procedures due to its simplicity and safety. Recent numerous studies have demonstrated the effectiveness of ESP blocks in acute pain management, using local anesthetics for their realization, but the true mechanism of action of this block has not yet been determined due to a paucity of evidence of the technique, so the role of ESPB in chronic pain management is limited. Even more, there are no studies using neurolytic techniques in the ESPB. Method: We describe the successful application of the neurolytic substance phenol in 2 female patients with severe pain due to breast cancer where the previous management of the analgesic medications, did not achieved an adequate pain control. Result: The neurolytic-ESPB produced an extensive multidermatomal sensory block, allowing the reduce of the previous total oral opioid requirement for prolonged periods of time after the neurolytic procedure, and reducing, in consequent, the related side effects, improving the quality of life of our patients. Conclusion: The true mechanism of ESPB has not yet been determined, and there is a paucity of evidence of its role in the management of chronic pain with this technique. This balance between effectiveness and safety in all areas of chronic pain, mainly with patients with refractive cancer-pain, where multimodal techniques are chosen, must follow the criteria of evidence-based medicine.
VL  - 8
IS  - 2
ER  -

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