Successful directional thoracic erector spinae plane block after failed lumbar plexus block in hip joint and proximal femur surgery

[...]we have previously noted the directional features of ESPB: cephalad orientation provides thoracic [2] and upper abdominal [3] dermatome analgesia, while a caudal orientation appears to be equally effective for lumbar coverage. Given the variability of the anatomic levels, and the relative ease of block placement in the thoracic region, we find the directional features of ESPB very advantageous as they allow us to place the ESPB faster and more reliably at a consistent site by simply varying the orientation of the catheter based on the desired dermatome coverage. [...]study will be needed to study the merit of this block in improved patient outcomes.Acknowledgement The authors thank the Stanford University Pediatric Regional Anesthesia (SUPRA) members for their contribution with the work. (www.pedsregional.stanford.edu).Conflict of interest disclosure BCH Tsui is the co-inventor of the catheter-over-needle assembly used in this case.