Perioperative Anesthesia Reports
Perioperative Anesthesia Reports
Case Report

Erector Spinae Plane (ESP) block associated with Transversus Abdominis Plane (TAP) block as a multimodal analgesia for breast cancer early reconstruction surgery. Case report

Vanessa Henriques Carvalho, Vinicius Marques, Angelica Braga

Downloads: 2
Views: 542


Breast cancer surgeries with early reconstruction have been changing in recent years, reinforcing the need for new anesthetic techniques. These techniques improve patients’ well-being, involving less pain, faster and better postoperative recovery, and reduction in opioid consumption. Within this perspective, ultrasound-guided regional blocks promote adequate intra and postoperative analgesia. Our aim was to demonstrate an anesthetic technique of interfascial plane blocks (ESP block associated with TAP block) to avoid acute pain in a patient submitted to radical mastectomy with early skin flap reconstruction. Analgesia assessment using a numerical rating pain scale, consumption of opioids and other analgesics, hemodynamic status, duration of analgesia, and adverse effects were monitored.


Nerve blocks; extended radical mastectomy; acute pain


1. Andersen KG, Kehlet H. Persistent pain after breast cancer treatment: a critical review of risk factors and strategies for prevention. J Pain. 2011;12(7):725-46. http://dx.doi. org/10.1016/j.jpain.2010.12.005. PMid:21435953.

2. Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The erector spinae plane blocks a novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med. 2016;41(5):621- 7. PMid:27501016.

3. Cassai A, Andreatta G. Will ESP block be the gold standard for breast surgery? We are not sure. Saudi J Anaesth. 2020;14(2):291-2. SJA_776_19. PMid:32317911.

4. Mustonen L, Aho T, Harno H, Sipilä R, Meretoja T, Kalso E. What makes surgical nerve injury painful? A 4-year to 9-year follow-up of patients with intercostobrachial nerve resection in women treated for breast cancer. Pain. 2019;160(1):246-56. pain.0000000000001398. PMid:30234699.

5. Forero M, Rajarathinam M, Adhikary SD, Chin KJ. Erector spinae plane block for the management of chronic shoulder pain: a case report. Can J Anaesth. 2018;65(3):288-93. 1010-1. PMid:29134518.

6. Baeriswyl M, Kirkham KR, Kern C, Albrecht E. The analgesic efficacy of ultrasound-guided transversus abdominis plane block in adult patients: a meta-analysis. Anesth Analg. 2015;121(6):1640-54. ANE.0000000000000967. PMid:26397443.

7. Aponte A, Sala-Blanch X, Prats-Galino A, Masdeu J, Moreno LA, Sermeus LA. Anatomical evaluation of the extent of spread in the erector spinae plane block: a cadaveric study. Can J Anaesth. 2019;66(8):886-93. http://dx.doi. org/10.1007/s12630-019-01399-4. PMid:31119551.

Submitted date:

Accepted date:

6462390ca953957fbc0dadf4 par Articles
Links & Downloads

Periop. Anesth. Rep.

Share this page
Page Sections