Multimodal Regional Anesthesia Combining Spinal and Erector Spinae Plane Block for Spine Surgery in a High-Risk Patient with Systemic Sclerosis: A Case Report.

Introduction: The erector spinae plane block (ESPB) is a novel regional anesthesia technique that is increasingly incorporated into multimodal analgesia as part of enhanced recovery after surgery (ERAS) pathways in various surgical procedures, including spine surgery.

Case presentation: We report the successful use of spinal anesthesia (SA), ESPB, and magnesium sulfate in a high-risk patient with systemic sclerosis and pulmonary fibrosis undergoing laminectomy. A multimodal approach was selected due to the patient's underlying condition. This strategy minimized respiratory complications associated with general anesthesia while providing effective surgical anesthesia and postoperative pain control without opioid-related complications.

Conclusions: Our case highlights the utility of ESPB, not only for postoperative pain management but also as a valuable adjunct to primary anesthesia, especially in high-risk patients.