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DO NOT Remove the Catheter: A Case Report on Pediatric Palliative Pain Management with an Erector Spinae Plane Block
Journal article   Open access

DO NOT Remove the Catheter: A Case Report on Pediatric Palliative Pain Management with an Erector Spinae Plane Block

Crystal Joseph, Alexander Eaton, Nathalie Peiris, Christina LaMonica, Erika Lindholm, Autumn Nanassy, Pravin Taneja and Aysha Hasan
Pain Medicine Case Reports, v 5(5), pp 277-281
31 Jul 2021
DOI: https://doi.org/10.36076/pmcr.2021.5.277
url
https://doi.org/10.36076/pmcr.2021.5.277View
Published, Version of Record (VoR) Open

Abstract

BACKGROUND: Erector spinae plane block (ESB) is a novel fascial plane regional anesthetic technique for pain management. The case report highlights the need for multidisciplinary education on regional nerve blockade in pediatric palliative medicine. CASE REPORT: The patient was a 5-year-old girl with relapsed metastatic Wilms tumor who presented with recurring malignant pleural effusion, necessitating chest tube insertion. She received a thoracic ESB via catheter to successfully manage uncontrolled pain. Radiation was needed, but radiation providers refused to continue ESB treatment, erroneously citing possible interactions between ESB and radiation therapy. The catheter was removed, and the patient suffered from complications before passing away. CONCLUSION: Interdisciplinary education on regional nerve blockade in pediatrics is imperative to prevent premature removal of anesthetic catheters during treatment, thereby causing unnecessary pain after risk of placement is undertaken. Further, we propose that the ESB is feasible for palliative pain management despite patient age and size. KEY WORDS: Acute pain anesthesiology, erector spinae plane block, palliative medicine, pediatric anesthesia, regional anesthesia

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