Hadi Ufuk YÖRÜKOĞLU, Yavuz GÜRKAN, Sami Kaan COŞARCAN, Mete MANİCİ

Toraks duvarı fasyal plan bloklar

Toraks cerrahisinde rejyonal anestezi uygulamasından uzun yıllardır anlaşılan sadece epidural anestezi ve torakal paraverteb- ral bloktur. Rejyonal anestezi uygulamalarında ultrasonografi kullanımının yaygınlaşması ile interfasyal plan blokları olarak adlandırılan yeni bloklar uygulamaya girmiştir. İnterfasyal plan blokları toraks cerrahisinde cerrahi anestezi sağlamakta yeter- siz iken klinik açıdan anlamlı analjezik etki sağlamaktadırlar. Bu derlemede toraks cerrahisinde günümüzde daha yaygın kabul gören pektoral bloklar, serratus anterior plan bloğu, erektor spina plan bloğu ve rhomboid bloklardan bahsedilecektir.

Ultrasound guided thoracic wall blocks

Epidural anesthesia and thoracic paravertebral blocks have been the mainstay of regional anesthesia for thoracic surgery for many years. Following introduction of ultrasound use during regional anesthesia practices, new blocks named interfascial plane blocks have been introduced into clinical practice. Although interfascial plane blocks fail to provide surgical anesthesia their contribution to providing analgesia is clinically important. In this review we mention the most commonly accepted blocks namely pectoral blocks, serratus anterior plane block, erector spinae plane block and rhomboid blocks.

PDF

___

1. Yeung JH, Gates S, Naidu BV, Wilson MJ, Gao Smith F. Pa- ravertebral block versus thoracic epidural for patients undergoing thoracotomy. Cochrane Database Syst Rev 2016;2(2):CD009121.
2. Campos JH, Seering M, Peacher D. Is the role of lipomo - sal bupivacaine the future of analgesia for thoracic sur - gery? An update and review. J Cardiothorac Vasc Anesth 2020;34(11):3093–3103.
3. Kelava M, Alfirevic A, Bustamante S, Hargrave J, Marci- niak D. Regional anesthesia in cardiac surgery: an over- view of fascial plane chest wall blocks. Anesth Analg 2020;131(1):127–35.
4. Willard FH, Vleeming A, Schuenke MD, Danneels L, Schleip. The thoracolumbar fascia: anatomy, function and clinical considerations. J Anat 2012;221(6):507–36.
5. Loukas M, Hullett J, Louis RG Jr, Holdman S, Holdman D. The gross anatomy of the extratorasic course of the inter- costabrachial nerve. Clin Anat 2006;19(2):106–11.
6. Blanco R, Fajardo M, Parras Maldonado T. Ultrasound desc- ription of Pecs II (modified Pecs I): a novel approach to bre- ast surgery. Rev Esp Anestesiol Reanim 2012;59(9):470–5.
7. Lee KS. Anatomic variation of the spinal orgins of lateral and medial pectoral nerves. Clin Anat 2007;20(8):915–8.
8. Chin KJ, Adhikary SD, Forero M. Understanding ESP and fascial plane blocks: a challenge to omniscience. Reg Anesth Pain Med 2018;43(7):807–8.
9. Gurkan Y, Kus A. Fascial plane blocks in regional anaest - hesia and new approaches. Turk J Anaesthesiol Reanim 2017;45(2):85–6.
10. Rahiri J, Tuhoe J, Svirskis D, Lightfoot NJ, Lirk PB, Hill AG. Systematic review of the systemic concentrations of local anaesthetic after transversus abdominis plane block and rectus sheath block. Br J Anaesth 2017;118(4):517–26.
11. Versyck B, Groen G, van Geffen GJ, Van Houwe P, Bleys RL. The pecs anesthetic blockade: A correlation between mag- netic resonance imaging, ultrasound imaging, reconstruc- ted cross-sectional anatomy and cross-sectional histology. Clin Anat 2019;32(3):421–9.
12. Blanco R, Parras T, McDonnell JG, Prats-Gallino A. Serratus plane block: a novel ultrasound-guided thoracic wall nerve block. Anaesthesia 2013;68(11):1107–13.
13. Uritz I, Ostling PZ, Novitch MB, Burns JC, Charipova K, Gress KL, et al. Truncal regional nerve blocks in clinical anesthesia practice. Best Pract Res Clin Anesthesiol 2019;33(4):559– 71.
14. Chin KJ. Thoracic wall blocks: from paravertebral to ret- rolaminar to serratus to erector spinae and back again – a review of evidence. Best Pract Res Clin Anesthesiol 2019;33(1):67–77
15. Forero M, Adhikary SD, Lopez H, Tsui C, Chin KJ. The erector spinae plane block: a novel analgesic technique in thoracic neuropathic pain. Reg Anesth Pain Med 2016;41(5):621–7.
16. Adhikary SD, Bernard S, Lopez H, Chin KJ. Erector spinae plane block versus retrolaminar block: a magnetic reso- nance ımaging and anatomical study. Reg Anesth Pain Med 2018;43(7):756–62.
17. Yang HM, ChoiYJ, Kwon HJ, O J, ChoTH, Kim SH. Comparison of injectate spread and nerve involvement between retro- laminar and erector spinae plane blocks in the thoracic re- gion: a cadaveric study. Anaesthesia 2018;73(10):1244–50.
18. Elsharkawy H, Maniker R, Bolash R, Kalasbail P, Drake RL, El- kassabany N. Rhomboid and Subserratus Plane Intercostal block: a cadaveric and clinical evaluation. Reg Anesth Pain Med 2018;43(7):745–51.
19. Versyck B, van Geffen GJ, Chin KJ. Analgesic efficacy of the Pecs II block: a systematic review and meta-analysis. Ana- esthesia 2019;74(5):663–73.
20. Kim DH, Oh YJ, Lee JG, Ha D, Chang YJ, Kwak HJ. Efficacy of ultrasound-guided serratus plane block on postoperative quality of recovery and analgesia after video-assisted tho- racic surgery: a randomized, triple-blind, placebo-control- led study. Anesth Analg 2018;126(4):1353–61.
21. Saad FS, El Baradie SY, Abdel Aliem MAW, Ali MM, Kotb TAM. Ultrasound-guided serratus anterior plane block ver- sus thoracic paravertebral block for perioperative analge- sia in thoracotomy. Saudi J Anaesth 2018;12(4):565–70.
22. Semyonov M, Fedorina E, Grinshpun J, Dubilet M, Refaely Y, Ruderman L, et al. Ultrasound-guided serratus anterior plane block for analgesia after thoracic surgery. J Pain Res 2019;12:953–60.
23. Gad M, Abdelwahap K, Abdallah A, Abdelkhalek M, Ab- delaziz M. Ultrasound guided erector spinae plane block compared to modified pectoral plane block for modi - fied radical mastectomy operations. Anesth Essays Res 2019;13(2):334–9.
24. Krishna SN, Chauhan S, Bhoi D, Kaushal B, Hasija S, Sang- dup T, et al. Bilateral erector spinae plane block for acu- te postsurgical pain in adult cardiac surgical patients: a randomized controlled trial. J Cardiothorac Vasc Anesth 2019;33(2):368–75.
25. Noss C, Anderson KJ, Gregory AJ. Erector spinae plane block for open heart surgery: a potential tool for improved analgesia. J Cardiothorac Vasc Anesth 2019;33(2):376–377.
26. Tulgar S, Ahiskalioglu A, De Cassai A, Gurkan Y. Efficacy of bilateral erector spinae plane block in the management of pain: current insights. J Pain Res 2019;12:2597–613.
27. Macaire P, Ho N, Nguyen T, Nguyen B, Vu V, Quach C, et al. Ultrasound-guided continuous thoracic erector spinae plane block within an enhanced recovery program is as - sociated with decreased opioid consumption and impro- ved patient postoperative rehabilitation after open cardi- ac surgery-a patient-matched, controlled before-and-after study. J Cardiothorac Vasc Anesth 2019;33(6):1659–67.
28. Adhikary SD, Liu WM, Fuller E, Cruz-Eng H, Chin KJ. The ef- fect of erector spinae plane (ESP) block on respiratory and analgesic outcomes in multiple rib fractures: a retrospecti- ve cohort study. Anaesthesia 2019;74(5):585–93.
29. Otero PE, Fuensalida SE, Russo PC, Verdiner N, Blanco C, Portela DA. Mechanism of action of the erector spinae plane block: distribution of dye in a porcine model. Reg Anesth Pain Med 2020;45(3):198–203.
30. Ivanusic J, Konishi Y, Barrington MJ. A Cadaveric Study Investigating the Mechanism of Action of Erector Spinae Blockade. Reg Anesth Pain Med 2018;43:567–71.
31. Cosarcan SK, Gurkan Y, Doğan AT, Ercelen O. Targeted mo- dification of erector spinae plane block. Acta Anesthesiol Scand 2020;64(2):276
32. Cosarcan SK, Doğan AT, Ercelen O, Gurkan Y. Superior cos- totransverse ligament is the main actor in permeability between the layers? Target-specific modification of erector spinae plane block. Reg Anesth Pain Med 2019;45(8):674– 5.
33. Aksu C, Gürkan Y. Do we still need central blocks while we have erector spinae plane block? Case of 2.5 month old in- fant. Rev Bras Anestesiol 2019;69(4):417–9.
34. Aksu C, Gurkan Y. Defining the indications and levels of erector spinae plane block in pediatric patients: a retrospective study of our current experience. Cureus 2019;11(8):e5348.
35. Ueshima H. Pneumothorax after the erector spinae plane block. J Clin Anesth 2018;48:12.
36. Aksu C, Gurkan Y. Erector spinae plane block: a new indica- tion with a new approach and a recommendation to redu- ce the risk of pneumothorax. J Clin Anesth 2019;54:130–1.
37. Aksu C, Gurkan Y. Erector spinae plane block: Safety in alte- red anatomy. Saudi J Anaesth 2019;13(3):177–8.
38. Elsharkawy H, Saifullah T, Kolli S, Drake R. Rhomboid inter- costal block. Anaesthesia 2016;71(7):856–7.
39. Schwartzmann A, Peng P, Maciel MA, Forero M. Mechanism of the erector spinae plane block: insights from a magnetic resonance imaging study. Can J Anaesth 2018;65:1165–6.
40. Manici M, Cosarcan SK, Salgın B, Gurkan Y. Rhomboid block contributes to relieving postoperative thoracotomy pain. J Clin Anesth 2020;68:110075.
41. Altıparmak B, Korkmaz Toker M, Uysal AI, Dere O, Ugur B. Evaluation of ultrasound-guided rhomboid intercostal nerve block for postoperative analgesia in breast cancer surgery: a prospective, randomized controlled trial. Reg Anesth Pain Med 2020;45(4):277–82.
42. Piraccini E, De Lorenzo E, Maitan S. Rhomboid inter- costal block for myofascial pain syndrome in a patient with amyotrophic lateral sclerosis. Minerva Anestesiol 2019;85(12):1367–9.
43. Tulgar S, Kızıltunç B, Thomas DT, Manukyan MN, Ozer Z. The combination of modified pectoral nerve block and rhomboid intercostal block provides surgical anesthesia in breast surgery. J Clin Anesth 2019;58:44.
44. Tulgar S, Thomas DT, Deveci U, Ozer Z. Ultrasound guided rhomboid intercostal block provides effective analgesia for excision of elastofibroma extending to the subscapular space: the first report of use in anesthesia practice. J Clin Anesth 2019;52:34–5.
45. Lonnqvist PA, Karmakar MK, Richardson J, Moriggl B. Da- ring discourse: should the ESP block be renamed RIP II block? Reg Anesth Pain Med 2021;46(1):57–60.
46. Fujii S, Bairagi R, Zhou JR. Transversus thoracic muscle pla- ne block. Biomed Res Int 2019;2019:1716365.
47. Onishi E, Toda N, Yamauchi M. Comparison of clinical ef - ficacy and anatomical investigation between retrolami- nar block and erector spinae plane block. Biomed Res Int 2019;2019:2578396.
48. Costache I, Neumann L, Ramnanan CJ, Goodwin SL, Pawa A, Abdallah FW, et al. The mid-point transverse processes to pleura (MTP) block: a new end-point for thoracic para- vertebral block. Anaesthesia 2017;72(10):1230–6.
49. Neal JM, Salinas FV, Choi DS. Local Anesthetic-Induced Myotoxicity After Continuous Adductor Canal Block. Reg Anesth Pain Med 2016;41(6):723–7.