Electrical Stimulation for Erector Spinae Plane Catheter Insertion

The erector spinae plane (ESP) block has been studied for analgesia in shoulder surgery as a phrenic nerve-sparing alternative. However, successful ESP catheter placement appears multifactorial, with failure mechanisms including lamination, plane collapse, or catheter overcoiling. Electrical stimulation (ES) is a common technique used in regional anesthesia to detect possible intraneural placement. ES of the erector spinae muscle complex may objectively guide proper interfascial catheter placement and improve local anesthetic spread. The primary goal of this study is to establish if ESP catheter placement with the addition of ES to ultrasound (US) guidance facilitates accurate catheter placement. This study will further characterize postoperative analgesia and the incidence of brachial plexus stimulation for patients who receive ES-assisted ESP catheter placement.

Inclusion Criteria:elective total or total reverse shoulder arthroplastyExclusion Criteria:inability to provide consenthistory of active opioid useemergency proceduresshoulder arthroscopypartial shoulder replacementshoulder resurfacingany revision shoulder surgeryany indwelling deep brain stimulator, pacemaker, and/or other neurostimulators