Tulgar S, Ahiskalioglu A, De Cassai A, et al. Efficacy of bilateral erector spinae plane block in the management of pain: current insights. J Pain Res. 2019 Aug 27;12:2597-2613. doi: 10.2147/JPR.S182128. eCollection 2019. (Systematic review)

Erector spinae plane block (ESPB) is a newly described interfascial plane block, and the number of articles on the bilateral application of ESPB is increasing in the literature. In this paper, in addition to analyzing bilateral ESPB cases and studies published so far, we aimed to review the relevant anatomy, describe the mechanism of spread of the injectant, demonstrate varying approaches to ESPB, and summarize case reports and clinical trials, as well as provide current insight on this emerging and popular block. Randomized controlled studies, comparative studies of ESPB versus other methods, and pharmacokinetic studies of bilateral applications must be the next step in clearly understanding bilateral ESPB.

Discipline Area Score
Physician 6 / 7
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Physician rater

Descriptive review on bilateral erector spinae plane block (bESPB) use for intraoperative analgesia (few reports exist of postoperative analgesia use). The review is useful for clinical practice, as this block (as well as other fascial plane blocks) is rapidly spreading. As the authors state in part, limitations exist. A few well designed RCTs have been published. Possibly the bESPB is not only a single block. Other fascial plane blocks factors as anatomical variations and practitioner dexterity or experience (perhaps one of the most important factors) could influence results. In addition, as it is a 'recently described' block, publication is from expert anesthesiologists or teams, or from first 'inventors' of the different approaches. All these factors might influence results. Despite this, this is a very good updated review of the topic.
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