Ultrasound-guided erector spinae nerve block for relief of endometriosis pain in the emergency department

case-report OA: closed CC0 ⤵ 2 in-corpus citations
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AI-generated summary by claude@2026-07, 2026-07-20

An ultrasound-guided erector spinae plane block with bupivacaine and dexamethasone provided significant pain relief for a patient with endometriosis in the emergency department.

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Abstract

Endometriosis is a debilitating chronic condition often accompanied by severe pelvic pain and infertility issues. When outpatient medical management is not adequate, controlling pain can be challenging for providers in the acute setting. We report the case of a 23-year-old female with a past medical history of endometriosis who presented to a freestanding emergency department with a chief complaint of 10/10 pelvic pain on a numeric rating scale. She had tried non-steroidal inflammatory medications and heat with no success. The patient had medication intolerances to opioid analgesics and was given ketorolac intramuscularly with no relief of her pain. The emergency physician discussed and offered to perform an erector spinae plane nerve block (ESPB) for pain relief. Ultrasonography was utilized for visualization of landmarks with a curvilinear transducer; a 20-gauge Pajunk® Sonoplex needle was used to inject a total of 100 mg bupivacaine 0.25% without epinephrine along with dexamethasone 10 mg under the bilateral erector spinae fascial planes at the T9 level. Post-procedure, the patient had significant improvement in pain and rated it a 2/10. Utilizing nerve blocks for endometriosis and other chronic pelvic pain in the acute care setting can serve as an effective alternative to opioids. In patients with multiple medication intolerances and for providers navigating pain control in the setting of a nationwide opioid crisis, ESPB blocks can help alleviate acute pain or exacerbations of chronic pain. This case demonstrates the first known use of an ESPB to relieve endometriosis pain in the emergency department.

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local Anesthetics, Local

Citation neighborhood (sparse)

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Cites (1)

Cited by (2)

References (17)

Cited by (2)

Source provenance

europepmc
last seen: 2026-08-08T06:08:32.324769+00:00
openalex
last seen: 2026-06-10T17:14:06.276822+00:00
pubmed
last seen: 2026-08-08T06:06:51.601946+00:00
unpaywall
last seen: 2026-08-08T06:39:30.753600+00:00
License: CC0 · commercial use OK