The Use of an Erector Spinae Plane Block for Perioperative Pain Management for a Neonatal Thoracotomy in a Resource-limited Setting: A Case Report

Adequate pain control for neonates undergoing thoracotomies can be challenging to accomplish without inducing respiratory depression from opioid administration. Premature neonates with cardiac and respiratory comorbidities are at increased risk of respiratory complications, and this risk further inc...

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Main Authors: Mellissa Delcont, Eunice Kageha, Amos Zacharia, Richard Hubbard
Format: Article
Language:English
Published: Surgical Society of Kenya 2025-07-01
Series:The Annals of African Surgery
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Online Access:https://www.annalsofafricansurgery.com/erector-spinae-plane-block
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author Mellissa Delcont
Eunice Kageha
Amos Zacharia
Richard Hubbard
author_facet Mellissa Delcont
Eunice Kageha
Amos Zacharia
Richard Hubbard
author_sort Mellissa Delcont
collection DOAJ
description Adequate pain control for neonates undergoing thoracotomies can be challenging to accomplish without inducing respiratory depression from opioid administration. Premature neonates with cardiac and respiratory comorbidities are at increased risk of respiratory complications, and this risk further increases in resource-limited environments with shortages of skilled healthcare providers and equipment. Erector spinae plane (ESP) blocks have been shown to reduce opioid consumption post-operatively in neonates undergoing thoracic surgery in middle and high sociodemographic countries, but there are scant reports in the literature translating such advances to low-resource settings. In this case report, we describe the use of an ESP block in a limited critical care capacity setting to facilitate the early extubation of a 5-day-old infant undergoing thoracotomy for tracheoesophageal fistula repair. This case highlights that low-risk, low-cost, and easily teachable regional anesthetic techniques such as ESP blocks offer an excellent option in a multitude of surgical settings.
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series The Annals of African Surgery
spelling doaj-art-fea7df16bfcc4a62b920644d5f59fa762025-08-21T08:52:00ZengSurgical Society of KenyaThe Annals of African Surgery1999-96742523-08162025-07-01223112116http://dx.doi.org/10.4314/aas.v22i3.6 The Use of an Erector Spinae Plane Block for Perioperative Pain Management for a Neonatal Thoracotomy in a Resource-limited Setting: A Case ReportMellissa Delcont0https://orcid.org/0000-0002-6178-5134Eunice Kageha1https://orcid.org/0009-0000-5061-1617Amos Zacharia2https://orcid.org/0009-0001-2524-4998Richard Hubbard3https://orcid.org/0000-0003-0302-1977Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA.Department of Anaesthesiology, The College of Anesthesiologists of East, Central and Southern Africa/Pan-African Academy of Christian Surgeons, AIC Hospital, Kijabe, Kenya. Department of Pediatric Anesthesiology, Mbeya Zonal Referral Hospital, University of Dar es Salaam – Mbeya College of Health and Allied Sciences, Mbeya, Tanzania.Division of Cardiovascular Anesthesiology, Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX, USA. Adequate pain control for neonates undergoing thoracotomies can be challenging to accomplish without inducing respiratory depression from opioid administration. Premature neonates with cardiac and respiratory comorbidities are at increased risk of respiratory complications, and this risk further increases in resource-limited environments with shortages of skilled healthcare providers and equipment. Erector spinae plane (ESP) blocks have been shown to reduce opioid consumption post-operatively in neonates undergoing thoracic surgery in middle and high sociodemographic countries, but there are scant reports in the literature translating such advances to low-resource settings. In this case report, we describe the use of an ESP block in a limited critical care capacity setting to facilitate the early extubation of a 5-day-old infant undergoing thoracotomy for tracheoesophageal fistula repair. This case highlights that low-risk, low-cost, and easily teachable regional anesthetic techniques such as ESP blocks offer an excellent option in a multitude of surgical settings.https://www.annalsofafricansurgery.com/erector-spinae-plane-blockerector spinae plane blockneonatal thoracotomyteflow-resource settingcase report
spellingShingle Mellissa Delcont
Eunice Kageha
Amos Zacharia
Richard Hubbard
The Use of an Erector Spinae Plane Block for Perioperative Pain Management for a Neonatal Thoracotomy in a Resource-limited Setting: A Case Report
The Annals of African Surgery
erector spinae plane block
neonatal thoracotomy
tef
low-resource setting
case report
title The Use of an Erector Spinae Plane Block for Perioperative Pain Management for a Neonatal Thoracotomy in a Resource-limited Setting: A Case Report
title_full The Use of an Erector Spinae Plane Block for Perioperative Pain Management for a Neonatal Thoracotomy in a Resource-limited Setting: A Case Report
title_fullStr The Use of an Erector Spinae Plane Block for Perioperative Pain Management for a Neonatal Thoracotomy in a Resource-limited Setting: A Case Report
title_full_unstemmed The Use of an Erector Spinae Plane Block for Perioperative Pain Management for a Neonatal Thoracotomy in a Resource-limited Setting: A Case Report
title_short The Use of an Erector Spinae Plane Block for Perioperative Pain Management for a Neonatal Thoracotomy in a Resource-limited Setting: A Case Report
title_sort use of an erector spinae plane block for perioperative pain management for a neonatal thoracotomy in a resource limited setting a case report
topic erector spinae plane block
neonatal thoracotomy
tef
low-resource setting
case report
url https://www.annalsofafricansurgery.com/erector-spinae-plane-block
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