Ultrasound-Guided Erector Spinae Plane Block for Breakthrough Cancer Pain in the Emergency Department: A Case Series

<b><i>Objectives:</i></b> Patients with cancer often experience severe pain, leading to emergency department (ED) visits and hospitalization. The erector spinae plane block (ESPB) has a multimodal mechanism that may treat cancer pain exacerbations. <b><i>Methods:</i></b> Data were collected via chart review for three patients with intra-abdominal cancer presenting to the ED for cancer-related abdominal pain and received a bilateral ESPB. Visual analog scale scores were collected pre- and post-procedurally. <b><i>Results:</i></b> The patient with colon cancer was pain-free postprocedurally and was discharged the following day. The patient with rectal cancer had a 75% reduction in pain and was discharged from the ED. The patient with pancreatic cancer had a 66% reduction in pain and was discharged the following day. <b><i>Conclusion:</i></b> Our findings suggest that the ESPB effectively treats cancer pain exacerbations and may expedite the bridge to home pain regimens. Furthermore, the ESPB may reduce the length of hospitalization and facilitate discharge.