Porcine erector spinae plane block model for simulation practice

To the Editor, Since its original description in 2016,1 the ultrasound-guided erector spinae plane (ESP) block, a regional anaesthesia technique, has become increasingly popular and the potential clinical applications have been increasing.2 A popular indication is analgesia for rib fracture management. Although randomised controlled trial (RCT) -level evidence for the ESP block is lacking in rib fractures, a recent retrospective cohort study3 has shown increased incentive spirometry values and reduced pain scores in the first 24 hours after implementation of the ESP block compared with before block administration. Alternative techniques, such as thoracic epidurals and paravertebral blockade, have greater potential for complications and steeper learning curves. The serratus anterior plane block’s efficacy has been questioned in patients with posterior rib fractures, with potential technical challenges if surgical emphysema or chest drains are present.3 This makes the ESP block an attractive proposition in management of these challenging patients. At our institution, a survey of senior anaesthetic trainees highlighted the need for training in ESP blockade as a tool in their armamentarium for rib fracture analgesia when a thoracic epidural was not feasible or practical. …