Analgesic Effect of Bilateral Bi-Level Erector Spine Planae Block in Adolescents for Surgical Treatment of Adolescent Idiopathic Scoliosis: Two Case Reports

Surgical intervention for Adolescent Idiopathic Scoliosis (AIS) involves three-dimensional correction of the defect and also resection of the entire thoracolumbar segment. Therefore, it causes severe pain in the postoperative period. Ultrasound guided Erector Spine Plane Block (ESP) performed bilaterally at two levels in combination with opioid and non-opioid analgesics can provide good postoperative analgesia as well as a reduction in the amount of opioid analgesic consumption. In this study, the ESP block was performed in two patients aged 14 and 18. After the performed anesthesiological examination and obtaining informed consent, the patients were scheduled for surgical treatment with open Posterior Spinal Fusion (PSF). The ESP block was performed after standard induction of anesthesia, in the prone position. In the postoperative period, continuous fentanyl infusion was also used in the patients. Pain was recorded at multiple time intervals in the first 48 hours according to the numeric pain rating scale NPRS. At all time intervals, the patients did not experience pain greater than 4 according to the NPRS. ESP block applied bilaterally at two levels is a reliable procedure for pain reduction in adolescents with PSF due to AIS.