ESRA19-0141 A case of ultrasound-guided erector spinae plane block using phenol for abdominal spasticity in a patient with spinal cord injury

Background and aims Ultrasound-guided erector spinae block (ESPB) has recently been used for postoperative pain or chronic pain in abdominal area. In patients with spinal cord injury, the management of spasticity might improve patient’s discomfort and quality of life. After obtaining the written consent, we planned ultrasound-guided ESPB with phenol injection for abdominal spasticity, causing dyspnea. Methods The patient was a 34-year-old male with a spinal cord injury at C4. He was suffering from abdominal spasticity followed by light dyspnea. the patient was set in sitting position and the Th8-11 was obtained with ultrasound machine with 15 MHz linear type probe. a 25-gauge, 25-mm needle was inserted to the posterior side of transverse processes. the needle tip was directed to the plane deep to the erector spinae muscle and superficial to the transverse processes. In both site of Th8-11, 3 ml of 8% phenol was injected. Results No complications were observed through this procedure. Patient’s self-assessment 2 weeks after the block was that spasticity of the back muscle was reduced to one-third and dyspnea had improved. the positive effect of the block for spasticity lasted for more than 6 months. Conclusions Ultrasound guided ESPB with phenol for abdominal spasticity was effective for a period longer than expected. ESPB can be applied to the treatment for spasticity of spinal cord injury patients.