Pediatr Emerg Med J.  2025 Jan;12(1):41-45. 10.22470/pemj.2024.01116.

A case report of ultrasound-guided erector spinae plane nerve block for pediatric renal colic in an emergency department

• Noble M
• Mitta M
• Landon J
• Byars D

• KMID: 2563131
• DOI: http://doi.org/10.22470/pemj.2024.01116

Abstract

Erector spinae plane nerve block (ESPB) has become a frequently used tool of analgesia among anesthesiologists or emergency physicians. The ESPB utilizes a guidance of point-of-care ultrasound and has a favorable safety profile. It had historically been used primarily in operative settings, but has become increasingly used for refractory pain in emergency settings. Here, we present a case of an adolescent with refractory renal colic pain who received an ESPB, performed by an emergency physician, with an improvement in the pain. To our knowledge, this is the first case report of ESPB use for renal colic in a pediatric patient.

Keyword

Analgesia; Emergency Medicine; Emergency Service, Hospital; Kidney Calculi; Nerve Block; Pediatric Emergency Medicine; Renal Colic; Ultrasonography

Figure

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  Fig. 1. Relevant anatomy for the erector spinae plane nerve block. Initial ultrasound scan using a curvilinear transducer shows a transverse view of the overlying midline thoracic SPs to identify both TPs (arrows, A). The structures are indicated in the illustration (B; modified from Pawa et al. (9) with permission of Springer Nature). SP: spinous process, TP: transverse process, ESM: erector spinae muscles, SCTL: superior costotransverse ligament.

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  Fig. 2. Example of patient positioning for the performance of the erector spinae plane nerve block on a standardized patient.

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  Fig. 3. Example of a curvilinear transducer and needle positioning for the erector spinae plane nerve block. The needle enters the skin from lateral to medial on a standardized patient.

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  Fig. 4. Ultrasound scan with the left TP centered in the image and a sample needle trajectory. TP: transverse process.

Reference

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