The erector spinae block: a novel approach to pain management in acute appendicitis.

This case report presents a 26-year-old female with a past medical history of polycystic ovarian syndrome (PCOS) and a tubal ligation that presented with 7/10 right lower quadrant abdominal pain that began 1 h prior to arrival. She stated that she felt like this was similar to her PCOS exacerbations in the past. During her evaluation, she underwent a computed tomography (CT) scan of her abdomen and pelvis that was remarkable for acute, uncomplicated appendicitis. She was given 4 mg of morphine for her pain with little response, so the offer was made for an erector spinae block that the patient elected to receive. After being consented both for the procedure and for research, she received a right-sided erector spinae block with 20 mL's of 0.2% ropivacaine (2 mg/mL) at the L1 vertebral level. After approximately 15 min, she stated that she had a reduction in her pain from a 6/10 to a 1/10 that persisted throughout the rest of her stay in the emergency department.