Role of erector spinae plane block in controlling functional abdominal pain: Case reports

RATIONALE: Functional abdominal pain is an intractable medical condition that often reduces quality of life. Celiac plexus block is a representative intervention for managing intractable abdominal pain. However, celiac plexus block can be technically difficult to perform and carries the risk of potential complications. During erector spinae plane block (ESPB), the injectate can enter the paravertebral space and reach the sympathetic chain. If local anesthetics spread to the sympathetic chain that supplies fibers to the splanchnic nerve, abdominal pain theoretically could be reduced. PATIENT CONCERNS: Three patients suffered from abdominal pain of unknown cause, and no medical abnormalities were found in various examinations. DIAGNOSIS: As a result of collaboration with related medical departments, the abdominal symptoms of the patients were suspected to be functional abdominal pain. INTERVENTIONS: We successfully controlled symptoms by performing ESPB at the lower thoracic level in 3 patients with functional abdominal pain. OUTCOMES: After the procedure, the patients’ abdominal pain improved significantly over several months. LESSONS: We suggest that lower thoracic ESPB could be an option for management of functional abdominal pain.