Bilateral high thoracic continuous erector spinae plane blocks for postoperative analgesia in a posterior cervical fusion

Posterior decompression and instrumentation of the cervical spine are associated with severe postoperative pain due to extensive soft tissue and muscle dissection during the surgery. In this case series, we describe bilateral continuous cervical erector spinae plane block (CESPB) placed at T1-2 through the thoracic erector spinae plane. A series of 4 patients underwent posterior cervical decompression and stabilization for various surgical indications. The CESPB block provides intense analgesia with low requirements of anesthetic drugs in the perioperative period and opioid-free analgesia in the postoperative period. The spread of local anesthetic was studied by performing CT contrast studies after obtaining informed consent.