Abdominal pain is one of the most common presenting chief complaints in the emergency department. Erector spinae plane block (ESPB) is an ultrasound-guided nerve block with proven effectiveness in treating visceral and somatic abdominal pain. Despite the increasing popularity of ESPB, its role in the management of nonsurgical abdominal pain has not yet been characterized. Our scoping review aims to synthesize current knowledge on the safety and efficacy of ESPB in the management of patients experiencing intractable, nonsurgical abdominal pain. We searched PubMed and Scopus to evaluate the existing literature on ESPB for nonsurgical abdominal pain. A total of 14 journal articles were included: 12 case-based studies, one systematic review, and one narrative review. All cases described the successful use of ESPB in treating abdominal pain refractory to oral or intravenous analgesic medications, and no complications were reported in any cases. This scoping review provides support for the use of ESPB to manage intractable, nonsurgical abdominal pain. ESPB has demonstrated efficacy in alleviating various conditions such as functional abdominal pain, renal colic, pancreatitis, herpetic pain, and cancer-related pain. Theoretical risks such as pneumothorax, bleeding, and infection are possible, although the studies reviewed did not report such complications.
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Comparison of quadro-iliac plane block and erector spinae plane block for postoperative analgesia management after single level lumbar discectomy surgery: a randomized, double-blind, controlled, prospective, multicenter study Engin İhsan Turan, Büşra Otlu Bıyıkoğlu, Volkan Özen, Selçuk Alver, Tarık Umutoğlu, Oğuzhan Cücü, Serdar Çevik, Bahadır Çiftçi, Ayça Sultan Şahin Journal of Anesthesia.2026; 40(1): 84. CrossRef
A Pilot Study Evaluating Erector Spinae Block Versus Saline For Emergency Department Patients With Ureterolithiasis Michael Secko, Daniel D. Singer, Gilbert Tetteh, Matthew Vitale, Benjamin Fombonne, Kristopher Bianconi, Rafael Fernandes, Andrea Gowie, Adam J. Singer The Journal of Emergency Medicine.2026; 83: 1. CrossRef
Efficacy of an erector spinae plane block for renal colic: a systematic review and meta-analysis Bart Gerard Jan Candel, Laura N Visser, Ewoud ter Avest, Milan L Ridderikhof, Bas De Groot, Rens Jacobs, Saskia Weltings, Rolf H H Groenwold, Leti van Bodegom, Wilbert B van den Hout, Marleen Kemper, Markus W Hollmann Emergency Medicine Journal.2025; 42(5): 317. CrossRef
Treatment of gastritis and gastroparesis symptoms with erector spinae plane block in the emergency department Richard J. Gawel, Michael Gottlieb, Frances S. Shofer, Michael Shalaby The American Journal of Emergency Medicine.2025; 96: 298.e1. CrossRef
The evolving role of truncal fascial plane blocks in non-surgical pain therapy: a narrative review Yi Gu, Yifan Qin, Jin Wu Frontiers in Medicine.2025;[Epub] CrossRef
Erector Spinae plane block for analgesia in patients with acute pancreatitis: a scoping review Karim Sadik, Khang Duy Ricky Le, William Keenan Next Research.2025; 2(4): 100874. CrossRef
Ultrasound-Guided Erector Spinae Plane Block in the Emergency Department: A Treatment for Intractable Sciatica Carlos A Gonzalez-Cobos, Miguel J Rosa Carrasquillo, Miguel F Agrait Gonzalez Cureus.2024;[Epub] CrossRef
Objective Pain control for hip fractures is often achieved via intravenous opioids. However, opioids can have dangerous adverse effects, including respiratory depression and delirium. Peripheral nerve blockade is an alternative option for pain control that reduces the need for opioid analgesia. The purpose of this study was to compare the use of femoral nerve blocks versus standard pain control for patients with hip fractures. Methods This retrospective study included adult patients presenting to the emergency department with isolated hip fractures between April 2021 and September 2022. The intervention group included all patients who received a femoral nerve block during this time. An equivalent number of patients who received standard pain control during that period was randomly selected to represent the control group. The primary outcome was preoperative opioid requirement, assessed by morphine milligram equivalents (MMEs). Results During the study period, 90 patients were included in each group. Mean preoperative MME was 10.3 (95% confidence interval [CI], 7.4–13.2 MME) for the intervention group and 14.0 (95% CI, 10.2–17.8 MME) for the control group (P=0.13). Patients who received a femoral nerve block also had shorter time from emergency department triage to hospital discharge (7.2 days; 95% CI, 6.2–8.0 days) than patients who received standard care (8.6 days; 95% CI, 7.210.0 days). However, this difference was not statistically significant (P=0.09). Conclusion Femoral nerve blockade is a safe and effective alternative to opioids for pain control in patients with hip fractures.
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Femoral Nerve Block Versus Pericapsular Nerve Group Block for Pain Management in Emergency Department Patients with Extracapsular Hip Fractures Kar Mun Cheong, Hua Li, Su Weng Chau, Cheng-Han Chiang, Yi-Kung Lee, Tou-Yuan Tsai Journal of Clinical Medicine.2026; 15(4): 1454. CrossRef
Femoral Nerve Block: A Review of the Relevant Applied Anatomy, Anatomical Variations, and Procedural Considerations Yuqian Dai, Michael J. Montalbano, Ewarld Marshall, Marios Loukas Clinical Anatomy.2026;[Epub] CrossRef
Ultrasound-guided fascia iliaca compartment block versus intravenous analgesia in geriatric hip fractures: a systematic review and meta-analysis of randomized trials demonstrating superior pain control Chang Liu, Shunyu Han, Ai Wei, Lina Yang, Mengchang Yang Frontiers in Medicine.2025;[Epub] CrossRef
Anirudh Ramachandran, Michelle Montenegro, Maninder Singh, Trevor Dixon, Waqas Kayani, Timothy Liang, Nick Yu, Srinivas Reddy, Anna Liveris, Mallika Manyapu, Alyssia A. McEwan, Vincent T. Nguyen, Nechama V. Sonenthal, Jill Corbo, Benjamin W. Friedman, Jeremy Sperling, Michael P. Jones, Michael Halperin
Clin Exp Emerg Med 2022;9(3):198-206. Published online September 20, 2022
Objective Hip fractures are associated with significant morbidity and mortality. Ultrasound-guided peripheral nerve blocks are a safe method to manage pain and decrease opioid usage. The pericapsular nerve group (PENG) block is a novel, potentially superior block because of its motor-sparing effects. Through training, simulation, and supervision, we aim to determine whether it is feasible to perform the PENG block in the emergency department.
Methods Phase 1 consisted of emergency physicians attending a workshop to demonstrate ultrasound proficiency, anatomical understanding, and procedural competency using a low-fidelity model. Phase 2 consisted of a prospective, observational, feasibility study of 10 patients with hip fractures. Pain scores, side effects, and opioid usage data were collected.
Results The median pain score at time 0 (time of block) was 9 (interquartile range [IQR], 6.5–9). The median pain score at 30 minutes was 4 (IQR, 2.0–6.8) and 3.5 (IQR, 1.0–4.8) at 4 hours. All 10 patients required narcotics prior to the initiation of the PENG block with a median dosage of 6.25 morphine milligram equivalents (MME; IQR, 4.25–7.38 MME). After the PENG block, only 30% of the patients required further narcotics with a median dosage of 0 MME (IQR, 0–0.6 MME) until operative fixation.
Conclusion In this feasibility study, PENG blocks were safely administered by trained emergency physicians under supervision. We demonstrated data suggesting a trend of pain relief and decreased opiate requirements, and further investigation is necessary to measure efficacy.
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Pain management in the perioperative orthogeriatric setting: Recommendations of the special interest group Orthogeriatrics of the German Geriatrics Society Vera Smolka, Cynthia Olotu, Mirja Modreker, Corinna Drebenstedt, Patricia Ardeleanu, Ilse Gehrke Zeitschrift für Gerontologie und Geriatrie.2026; 59(2): 99. CrossRef
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Pericapsular Nerve Group Block-Augmented Analgesia vs. Conventional Opioid Analgesia for Hip Fracture Patients in the Emergency Department: A Comparative Effectiveness Study William Murk, Ariella Gartenberg, Jonathan Maik, Michelle A. Montenegro, Sarika Antora, Aamir Bandagi, Michael Boulay, Julie Clemmensen, Trevor Dixon, Michael Jones, Kaushal Khambhati, Nicole Leonard-Shiu, Anna Liveris, Philip O’Donnell, Anthony Scoccimar The Journal of Emergency Medicine.2025; 79: 232. CrossRef
High-Utility Ultrasound-Guided Nerve Blocks for Emergency Department Use Joseph Brown, Michael Prats, Hilary Stroud, Andrew Goldsmith, Arun Nagdev The Journal of Emergency Medicine.2025; 79: 151. CrossRef
Response to Letter to the Editor on “Pericapsular Nerve Group (PENG) Block-Augmented Analgesia vs. Conventional Opioid Analgesia for Hip Fracture Patients in the Emergency Department: A Comparative Effectiveness Study” William Murk, Ariella Gartenberg, Jonathan Maik, Michelle A. Montenegro, Sarika Antora, Aamir Bandagi, Michael Boulay, Julie Clemmensen, Trevor Dixon, Michael Jones, Kaushal Khambhati, Nicole Leonard-Shiu, Anna Liveris, Philip O’Donnell, Anthony Scoccimar The Journal of Emergency Medicine.2025; 79: 654. CrossRef
Effect of early ultrasound-guided femoral nerve block on preoperative opioid consumption in emergency patients with hip fracture: a randomized trial Camille Gerlier, Rami Mijahed, Audrey Fels, Samir Bekka, Romain Courseau, Anne-Lyse Singh, Olivier Ganansia, Gilles Chatellier European Journal of Emergency Medicine.2024; 31(1): 18. CrossRef
Local anesthetic systemic toxicity: awareness, recognition, and risk mitigation in the emergency department Michael Shalaby, Raghav Sahni, Richard Hamilton Clinical and Experimental Emergency Medicine.2024; 11(2): 121. CrossRef
Rib fractures account for a significant number of emergency department visits each year. A patient’s disposition often depends on the severity of rib fractures, comorbidities, and ability to achieve adequate analgesia. We present a 44-year-old male patient with severe pain secondary to rib fractures. The initial disposition was to admit for pain control. However, upon performing a serratus anterior plane block, patient was functionally appropriate for discharge with proper return precautions. Serratus anterior plane block is within the skillset of the emergency physician and can be used to achieve analgesia for rib fractures without the sedative and respiratory depressive effects associated with opioids.
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In recent years, several techniques of regional anesthesia have been proposed to provide analgesia to the anterior thoracic cage; notably, most of these techniques require a parasternal approach. However, in this context, the potential role of a more common and well-established technique, namely the modified pectoral nerve block (known as PECS II block), has been poorly investigated. Here, we describe a case involving a patient with bilateral anterolateral multiple rib fractures associated with sternum fracture, who was successfully treated using bilateral PECS II blocks. Our experience indicates that the PECS II block can provide excellent analgesia in cases involving anterior rib and sternum fractures. Because it is easier to perform and may be safer than other parasternal techniques, the PECS II block should be considered when providing analgesia for traumatic injuries of the anterior thorax.
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