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Ultrasound guidederector spinae plane (ESP) block is effective in thoracoabdominal surgeries for controlof postoperative pain. With the increasing use of adjuvants in local anesthetics, the block duration can beprolonged. A 21 year old female patient diagnosed with mediastinal teratoma was planned for resectionof tumour through median sternotomy. She was given general anaesthesia with standard drugs. At the endof surgery, patient was given bilateral ultrasound guided ESP block with 10 ml of injection ropivacaine0.2% with 50 mg tramadol at T5 level on each side. Visual analogue scores (VAS) were in the range of2-3 for first 24 hours and 1 from 24-48 hours. Patient didn’t demand any analgesic in postoperative periodfor first 48 hours and was completely painfree. Severe postoperative pain of sternotomy can be controlledeffectively by giving ultrasound guided ESP block. Moreover, tramadol is a useful adjuvant to prolong theblock duration upto 48 hours.Keywords: Ultrasound guided, Erector spinae plane (ESP) block, Tramadol.

Tramadol as an adjuvant to ropivacaine in utrasound guided erector spinae plane block for postoperative analgesia after sternotomy