Search

We present the case of a comorbid patient with Chronic Obstructive Pulmonary disease who developed a pulmonary herniation secondary to a coughing episode. He complained of severe and invalidating somatic pain in the herniation area, pain score was 4 out of 10 in the Verbal Numeric Scale (VNS) at rest, that worsened with cough to 9 out of 10. Buprenorphine and acetaminophen were initiated with only slight improvement in pain. Surgical reparation was discarded. An erector spinae plane nerve block (ESP block) was performed with improvement in the VNS to 0 out of 10 at rest and 6 out of 10 with cough. After the procedure, the patient only needed acetaminophen as analgesic for pain relief, and the improvement was maintained in time. The ESP block was described in 2016, and since then there has been growing evidence of its safety and efficacy in post-operative analgesia for breast, thoracic and abdominal surgery. The main ESP block benefits compared to similar blocks are the relative less incidence of pneumothorax, less systemic absorption of local anaesthetics and the simplicity of its performance. Although there is less evidence in chronic pain, it has been described in the treatment of post thoracotomy chronic pain with good results. This case is described because of the great clinical improvement in an uncommon and very symptomatic disease. [ABSTRACT FROM AUTHOR]