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Erector spinae catheter for post-thoracotomy pain control in a premature neonate

Ensuring respiratory stability with early tracheal extubation and adequate pain control is challenging in premature neonates after thoracotomy. Continuous erector spinae plane (ESP) block, a relatively new truncal nerve block, has the potential to provide analgesia for thoracic surgeries while reduc...

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Autores principales: Swenson Schalkwyk, Anna, Flaherty, James, Hess, Donavon, Horvath, Balazs
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478038/
https://www.ncbi.nlm.nih.gov/pubmed/32900720
http://dx.doi.org/10.1136/bcr-2020-234480
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author Swenson Schalkwyk, Anna
Flaherty, James
Hess, Donavon
Horvath, Balazs
author_facet Swenson Schalkwyk, Anna
Flaherty, James
Hess, Donavon
Horvath, Balazs
author_sort Swenson Schalkwyk, Anna
collection PubMed
description Ensuring respiratory stability with early tracheal extubation and adequate pain control is challenging in premature neonates after thoracotomy. Continuous erector spinae plane (ESP) block, a relatively new truncal nerve block, has the potential to provide analgesia for thoracic surgeries while reducing opioid use. However, there have been only a few reports utilising this technique in infants, and none in preterm neonates. We present the perioperative pain management of a preterm neonate requiring thoracotomy. Epidural analgesia was deemed contraindicated due to coexisting coagulopathy; therefore, an ESP catheter was placed. The patient was extubated at the end of the surgery and had excellent pain control with rectal acetaminophen, chloroprocaine infusion via the ESP catheter and with minimal opioid requirement. Continuous ESP block may be safe and effective for postoperative pain management in coagulopathic premature neonates. Chloroprocaine is an effective local anaesthetic in the erector spinae compartment, which has not been previously reported.
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spelling pubmed-74780382020-09-21 Erector spinae catheter for post-thoracotomy pain control in a premature neonate Swenson Schalkwyk, Anna Flaherty, James Hess, Donavon Horvath, Balazs BMJ Case Rep Novel Treatment (New Drug/Intervention; Established Drug/Procedure in New Situation) Ensuring respiratory stability with early tracheal extubation and adequate pain control is challenging in premature neonates after thoracotomy. Continuous erector spinae plane (ESP) block, a relatively new truncal nerve block, has the potential to provide analgesia for thoracic surgeries while reducing opioid use. However, there have been only a few reports utilising this technique in infants, and none in preterm neonates. We present the perioperative pain management of a preterm neonate requiring thoracotomy. Epidural analgesia was deemed contraindicated due to coexisting coagulopathy; therefore, an ESP catheter was placed. The patient was extubated at the end of the surgery and had excellent pain control with rectal acetaminophen, chloroprocaine infusion via the ESP catheter and with minimal opioid requirement. Continuous ESP block may be safe and effective for postoperative pain management in coagulopathic premature neonates. Chloroprocaine is an effective local anaesthetic in the erector spinae compartment, which has not been previously reported. BMJ Publishing Group 2020-09-07 /pmc/articles/PMC7478038/ /pubmed/32900720 http://dx.doi.org/10.1136/bcr-2020-234480 Text en © BMJ Publishing Group Limited 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Novel Treatment (New Drug/Intervention; Established Drug/Procedure in New Situation)
Swenson Schalkwyk, Anna
Flaherty, James
Hess, Donavon
Horvath, Balazs
Erector spinae catheter for post-thoracotomy pain control in a premature neonate
title Erector spinae catheter for post-thoracotomy pain control in a premature neonate
title_full Erector spinae catheter for post-thoracotomy pain control in a premature neonate
title_fullStr Erector spinae catheter for post-thoracotomy pain control in a premature neonate
title_full_unstemmed Erector spinae catheter for post-thoracotomy pain control in a premature neonate
title_short Erector spinae catheter for post-thoracotomy pain control in a premature neonate
title_sort erector spinae catheter for post-thoracotomy pain control in a premature neonate
topic Novel Treatment (New Drug/Intervention; Established Drug/Procedure in New Situation)
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478038/
https://www.ncbi.nlm.nih.gov/pubmed/32900720
http://dx.doi.org/10.1136/bcr-2020-234480
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