ESP Block for Total Hip Arthroplasty

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BLADEMDA

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Would anyone here consider doing a single shot ESP block for an anterior hip replacement? What about at an outpatient? I realize the pain is minimal after an anterior hip replacement but the ESP block is easy, safe and simple to perform.

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Erector Spinae Plane Block for THA Allows Early Ambulation​


Clinicians looking to increase early ambulation in patients undergoing elective total hip arthroplasty (THA) may appreciate the continuous erector spinae plane (ESP) block, according to a recent study. The research found that replacing fascia iliaca catheters with continuous ESP blocks increased ambulation distance achieved on the first day after surgery.
“Our standard of care here for hip replacements has been the fascia iliaca catheter,” said Lei Xu, MD, a fellow in regional anesthesia at Stanford University in California. “However, the block can also cause quadriceps weakness, which can then interfere with walking.
“The ESP block was first published in 2016, and case reports suggested it can be used for pain relief after a variety of different surgeries, including hip surgery,” Xu added. “So we decided to examine our switch to ESP block catheters in these patients, which would afford patients continuous pain relief throughout the day without any motor weakness.”
 




 
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I've tried a number of regional approaches for THA and none of them seem to do much: in the older population you might feel that you have a positive effect but even without the block they do ok so i'm not sure that it really has an effect.
 
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Hip replacement patients do great with injection by surgeons and multi-modal analgesia. Don’t think blocks are necessary for them unless it’s for $$
 
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