Grant: Travel Awards - Institute Community Support

Back pain is one of the most common reasons for emergency department (ED) visits. It has significant negative impact to patient's quality of life. Current clinical guidelines aim at pain reduction with pharmacological treatment. Most common medications administered to patients are Non-steroidal anti-inflammatory drugs (NSAIDs), opioids and muscle relaxants. However, there are significant mediations side effects especially in high-risk groups such as the elderly. With the emergence of point-of-care ultrasound use, ultrasound guided regional anesthesia techniques have become more commonplace in the emergency department setting. Regional anesthesia for pain reduction may obviate or reduce the need for opiate therapy and it's associated side effects and also reduces ED length of stay for patient with severe pain. Ultrasound guided erecter spinae plane block is a recently described regional anesthetic technique. It is simple, safe and suitable to perform in the ED setting. The ESP block has been described for the treatment of thoracic pain such as rib fractures. The Co-investigator noted significant back pain relief when performing the block on a patient with rib fractures and concomitant paravertebral pain. The paravertebral pain was completed relieved with the ESP block (while the rib pain was only partially resolved). The Co-investigator went on to perform the ESP block on a number of back pain patients and initial results were overwhelmingly positive. Nine patients clinically improved after the block. Seven of them were extremely satisfied with the result of the block. The patients were phoned to inquire about duration of ongoing pain relief. The block duration range from eight hours to four weeks. The investigators wish to report the results of this limited number of initial patients. A comparative trial will be planned with standard analgesia therapy in the near future.