Brazilian Journal of Pain
Brazilian Journal of Pain
Case Report

Lumbar erector spinae plane block for total hip arthroplasty analgesia. Case report

Bloqueio do plano eretor da espinha lombar para analgesia de artroplastia total de quadril. Relato de caso

Artur Salgado de Azevedo; Hermann dos Santos Fernandes; Waldir Cunha Júnior; Adilson Hamaji; Hazem Adel Ashmawi

Downloads: 0
Views: 237


BACKGROUND AND OBJECTIVES: Total hip replacement surgeries may result in intense postoperative pain. There are many analgesia techniques available in clinical practice and lumbar erector spine plane (LESP) block may be an option of an effective technique with milder adverse effects and easier execution.

CASE REPORT: Female patient, 23-year-old, allergic to morphine and tramadol, underwent a total left hip arthroplasty under mild sedation, no opioid spinal anesthesia and ultrasound guided LESP. After the surgery the patient’s pain was under control, and methadone rescue analgesia was not used.

CONCLUSION: LESP block is easy to perform and may be effective for postoperative analgesia in hip surgeries, with fewer adverse effects than other techniques.


Analgesia, Anesthesia conduction, Arthroplasty replacement hip


JUSTIFICATIVA E OBJETIVOS: Artroplastia total de quadril pode evoluir com dor pós-operatória intensa. Há várias técnicas disponíveis na prática clínica para analgesia. O bloqueio do plano eretor da espinha lombar (LESP block) pode ser uma opção efetiva, de fácil execução e efeitos adversos mais leves.

RELATO DO CASO: Paciente do sexo feminino, 23 anos, alérgica a morfina e tramadol, submetida à artroplastia total de quadril sob sedação leve, anestesia subaracnóidea sem opioides e LESP block guiado por ultrassonografia. Evoluiu com controle de dor efetivo, sem uso de metadona de resgate.

CONCLUSÃO: LESP block é fácil de ser executado, pode ser efetivo para analgesia pós-operatória de cirurgias de quadril e apresenta menos efeitos adversos que outras técnicas.


Analgesia, Anestesia regional, Artroplastia de quadril


Liang C, Wei J, Cai X, Lin W, Fan Y, Yang F. Efficacy and safety of 3 different anesthesia techniques used in total hip arthroplasty. Med Sci Monit. 2017;23:3752-9.

Adhikary SD, Pruett A, Forero M, Thiruvenkatarajan V. Erector spinae plane block as an alternative to epidural analgesia for post-operative analgesia following video-assisted thoracoscopic surgery: a case study and a literature review on the spread of local anaesthetic in the erector spinae plane. Indian J Anaesth. 2018;62(1):75-8.

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.

Vidal E, Gimenez H, Forero M, Fajardo M. Erector spinae plane block: a cadaver study to determine its mechanism of action. Rev Esp Anestesiol Reanim. 2018;65(9):514-9.

Ahiskalioglu A, Tulgar S, Celik M, Ozer Z, Alici HA, Aydin ME. Lumbar erector spinae plane block as a main anesthetic method for hip surgery in high risk elderly patients: initial experience with a magnetic resonance imaging. Eurasian J Med. 2020;52(1):16-20.

Santonastaso DP, De Chiara A, Kraus E, Bagaphou TC, Tognu A, Agnoletti V. Ultrasound guided erector spinae plane block: an alternative technique for providing analgesia after total hip arthroplasty surgery?. Minerva Anestesiol. 2019;85(7):801-2.

Tulgar S, Kose HC, Selvi O, Senturk O, Thomas DT, Ermis MN. Comparison of ultrasound-guided lumbar erector spinae plane block and transmuscular quadratus lumborum block for postoperative analgesia in hip and proximal femur surgery: a prospective randomized feasibility study. Anesth Essays Res. 2018;12(4):825-31.

Tulgar S, Selvi O, Senturk O, Ermis MN, Cubuk R, Ozer Z. Clinical experiences of ultrasound-guided lumbar erector spinae plane block for hip joint and proximal femur surgeries. J Clin Anesth. 2018;47(1):5-6.

Tulgar S, Senturk O. Ultrasound guided erector spinae plane block at L-4 transverse process level provides effective postoperative analgesia for total hip arthroplasty. J Clin Anesth. 2018;44:68.

Foss NB, Kristensen MT, Palm H, Kehlet H. Postoperative pain after hip fracture is procedure specific. Br J Anaesth. 2009;102(1):111-6.

Ibrahim MS, Twaij H, Giebaly DE, Nizam I, Haddad FS. Enhanced recovery in total hip replacement: a clinical review. Bone Joint J.. 2013;95-B(12):1587-94.

Kang H, Ha YC, Kim JY, Woo YC, Lee JS, Jang EC. Effectiveness of multimodal pain management after bipolar hemiarthroplasty for hip fracture: a randomized, controlled study. J Bone Joint Surg Am. 2013;95(4):291-6.

Kearns RJ, Macfarlane AJ, Anderson KJ, Kinsella J. Intrathecal opioid versus ultrasound guided fascia iliaca plane block for analgesia after primary hip arthroplasty: study protocol for a randomised, blinded, noninferiority controlled trial. Trials. 2011;12:51.

Tulgar S, Aydin ME, Ahiskalioglu A, De Cassai A, Gurkan Y. Anesthetic techniques: focus on lumbar erector spinae plane block. Local Reg Anesth. 2020;13:121-33.

Submitted date:

Accepted date:

60873f61a953950893708872 brjp Articles


Share this page
Page Sections