Interesting, Jon! If I read this correctly, ESP is no better than control. SAPB has the unenviable position of being likely worse than the control group!

ICBs, PVBs, and TEAs for the win!

The authors seem to go silent in the discussion and conclusions re: ESP, not sure why.

No blocks yet over here. Steve Coppens' study on anterior QL for laparoscopic colorectal surgery showed no benefit over placebo, despite sensory blockade.

pubmed.ncbi.nlm.nih.gov/37970976/

Duration may be a factor. 24 hr minimum for IV lidocaine, at least for colorectal surgery.

journals.lww.com/anesthesia-a....

If only mine always unzippered like that! For me, it's more like expanding the deeper muscle, then the superficial one, then losing the plane entirely in various pockets of local!

I thought anesthesia was simply the induction of a state of insensibility (to surgical stimulus). This would fit for all forms of anesthesia. While Wendell Holmes, in his letter to Morton, was describing ether general anesthesia, it fits nicely for local-regional as well.

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