Hi Dr Chin!! Tks for your clear presentation of the topic! I’m in the dilemma of blocking patient before vs after surgery. Many surgeons are always in a hurry and want to get started and push the block to the end. I truly believe in the preemptive approach whenever possible. However, in spine surgery, we do use neuro monitoring, SSEP, EMG, MEP, EEG, etc. Does pre-incision lumbar ESP in any way affect the neuro monitoring when baseline is being obtained before blocking? Will it alter the findings intraop? Will blocking after be near as effective as before? Since, this is a new addition to my practice, I’d appreciate your insights. Thanks!!
I have never observed it to prevent neuromonitoring, which is standard in our hospital. My neuromonitoring techs say the signals are fine. This is with both TLIP and ESP (at thoracic and lumbar levels).
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Thank you for your insights and reflections. Clear and concise, your presentation is both highly engaging and instructive.
Hi Dr Chin!! Tks for your clear presentation of the topic! I’m in the dilemma of blocking patient before vs after surgery. Many surgeons are always in a hurry and want to get started and push the block to the end. I truly believe in the preemptive approach whenever possible. However, in spine surgery, we do use neuro monitoring, SSEP, EMG, MEP, EEG, etc. Does pre-incision lumbar ESP in any way affect the neuro monitoring when baseline is being obtained before blocking? Will it alter the findings intraop? Will blocking after be near as effective as before? Since, this is a new addition to my practice, I’d appreciate your insights. Thanks!!
I have never observed it to prevent neuromonitoring, which is standard in our hospital. My neuromonitoring techs say the signals are fine. This is with both TLIP and ESP (at thoracic and lumbar levels).