Treatment of gastritis and gastroparesis symptoms with erector spinae plane block in the emergency department

Flares of gastritis and gastroparesis are commonly encountered in the emergency department (ED) and can often be distressing for patients. These conditions can be difficult to symptomatically manage with conventional therapies, including acid reducing medications, analgesics, and pro-motility agents. We describe two patients with acute gastritis and three patients with gastroparesis flares who reported considerable symptom improvement after a unilateral thoracic ultrasound-guided erector spinae plane block (ESPB). One gastritis patient was admitted to the hospital for endoscopy but did not require any opioids until she was sedated for the procedure, while the other gastritis patient reported complete symptom relief and elected to be discharged from the ED. All three patients with gastroparesis flares reported considerable improvement in their symptoms and were able to be discharged home rather than be admitted for continued symptom management. The ESPB may be an effective tool for emergency physicians to manage acute gastritis and gastroparesis flares in the ED.