BoardsBridgeErector Spinae Plane (ESP) Block — Ultrasound-Guided Truncal Analgesia
Fascial plane block deep to the erector spinae muscle at the transverse process for thoracic, abdominal, and chest wall pain.
Ultrasound-guided ESP block deposits 20-25 mL of local anesthetic deep to the erector spinae muscle at the T5 transverse process, producing C7-T8 spread for thoracic, chest wall, and selected abdominal analgesia with a more superficial target than the paravertebral block.
If you forget
T5 transverse process, deep to erector spinae anterior fascia — that's the target.
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Key numbers
- 20-25 mL per level (0.2% ropivacaine)
- 5-mL aliquots under direct vision
- C7 to T8 spread with 20 mL at T5
- Catheter advanced 5 cm past needle tip
- Infusion 5-8 mL/h
- 17-G, 8-cm needle
- First described 2016 (Forero et al.)
Uri Rozen, MD — Licensed Physician, Israel
Source guidelines: Millers Anesthesia 10 Ch49 Anesthesia FOR Thoracic Surgery · Millers Anesthesia 10 Ch42 Peripheral Nerve Blocks AND Ultrasound Guidance FOR Regional · Millers Anesthesia 10 Ch77 Acute Postoperative Pain
Re-review cadence: 12 months from reviewed date.
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Card ID: esp-block · Path: aba.regional.truncal.esp-block