Bilateral ultrasound-guided erector spinae plane block for postoperative pain management in surgical repair of pectus excavatum via Ravitch technique

Patients submitted to repair of Pectus Excavatum (PE) via Ravitch technique can experience severe postoperative pain due to dissection of pectoralis major and rectus abdominis muscles, resection of deformed cartilages, transverse wedge sternal osteotomy, and temporary fixation of the sternum with metal bar. Adequate pain management is mandatory to encourage early mobilization and facilitate deep breathing. Benefits of thoracic epidural (TE), considered for years the gold standard, have been recently questioned and there is increasing evidence that less invasive regional techniques can be successfully employed.