A 42-year-old male (45 kg; 155 cm) with right Pancoast tumor severe pain (7/10 on NRS) from 5 months in dermatome distribution from C5 to T3, incompletely relieved on medical treatment. Right ESP block was given at T2 level in the sitting position. Following administration of 20 ml of 0.375% ropivacaine and 40 mg triamcinolone, pain was relieved in few minutes (1/10 on NRS) with sensory blockade from C3 to T5 on the right side. NRS score was noted for 24 h []. The patient was discharged with oral medications tapered. The patient was still pain-free without consumption of any other oral analgesics at the follow-up after 2 months.
Case 3: A 26 years old female (weight 47 kg, ASA status II) was scheduled for left total hip arthroplasty. She was diagnosed with ankylosing spondylitis 14 years ago, with pain on almost all major joints of her body. She could not stand or walk because of bilateral femoral head necrosis. She had a family history of ankylosing spondylitis, with her father also suffered from this disease. Physical examination revealed rigidity of neck and left hip joint. X-ray of the thoracic and lumbar vertebrae reported rigidity of the spine, calcification of interspinous ligament. X-ray of bilateral sacra-iliac joints, hip joints, knees and ankles reported narrow joint space, osteoproliferation, bone defect and joint deformity. The chest X-ray reported texture enhancement of bilateral lungs and infection of right lower lobe.