The thoracic erector spinae plane (ESP) block is suggested to potentially affect the stellate ganglion, a key component of the sympathetic nervous system, thereby influencing autonomic functions. Changes in optic nerve sheath diameter (ONSD) are used as indicators of intracranial pressure changes. This study aims to investigate the effects of the ESP block on ONSD, providing insights into its impact on the stellate ganglion and enhancing the understanding of the ESP block's safety and efficacy.
Adults with neck, shoulder, and arm pain
Those with complex regional pain syndrome
Age between 18-65 years
Both genders
Those who refuse procedures and tests
Individuals with conditions that can increase intracranial pressure
Those with severe heart failure
Individuals with second or third-degree atrioventricular block
* Adults with neck, shoulder, and arm pain * Those with complex regional pain syndrome The study will include 15 adult patients who are planned to receive T2-ESP block treatment. * Age between 18-65 years * Both genders * ASA physical status I-II
Cohort
Prospective
thoracic erector spinae plane (ESP) block
Procedure/SurgeryThe thoracic erector spinae plane (ESP) block is a regional anesthesia technique used for pain management in complex regional pain syndrome. This procedure involves injecting 20 ml of 0.25% bupivacaine into the deep layers of the erector spinae muscles. The patient is positioned appropriately, and the injection site is identified using anatomical landmarks and ultrasound guidance, at the T2 level. A needle is then inserted perpendicularly until it contacts the transverse process, at which point the local anesthetic is administered. The primary objective is to provide significant pain relief.
Optic nerve sheath diameter (ONSD)
To investigate the change in optic nerve sheath diameter (ONSD) following the thoracic erector spinae plane (ESP) block.
Pain relief Visual Analog Scale (VAS)
The Visual Analog Scale (VAS) is a tool for measuring pain intensity, using a line marked with "no pain" (0) at one end and "worst pain imaginable" (10) at the other. Patients mark a point on the line that reflects their pain level, and the distance from the "no pain" end to the mark is recorded as the VAS score. This straightforward, subjective measure provides a quantitative assessment of pain, useful for tracking changes over time, evaluating treatment effectiveness, and enhancing communication between patients and healthcare providers.
Monitoring of Perfusion Index (PI)
The perfusion index (PI) is a numerical value that reflects the pulsatile blood flow in peripheral tissues, measured non-invasively using a pulse oximeter. It indicates the strength of the blood flow at the sensor site, providing valuable information about peripheral perfusion.
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