Regional anaesthesia: erector spinae plane block: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Regional anaesthesia: erector spinae plane block

Sample item

In an erector spinae plane block, where is the local anaesthetic deposited?

AInto the subarachnoid spaceBBetween the pectoralis major and minor musclesCInto the epidural spaceDDeep to the erector spinae muscle, at the tip of the transverse process

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Deep to the erector spinae muscle, at the tip of the transverse process

The erector spinae plane block places local anaesthetic in the fascial plane between the erector spinae muscle and the transverse process under ultrasound guidance. The drug spreads to the dorsal and ventral rami, giving thoracic or abdominal wall analgesia. It is simpler and safer than neuraxial or paravertebral blocks.

Option by option

A. Into the subarachnoid space
It is not an intrathecal technique.
B. Between the pectoralis major and minor muscles
The plane between pectoralis major and minor is used in the PECS block.
C. Into the epidural space
The block is a fascial plane block and not an epidural.
D. Deep to the erector spinae muscle, at the tip of the transverse process (correct)
Correct. The injection lies deep to the muscle at the transverse process.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Deep to the erector spinae muscle, at the tip of the transverse process. The erector spinae plane block places local anaesthetic in the fascial plane between the erector spinae muscle and the transverse process under ultrasound guidance.

Why is "Into the subarachnoid space" not the answer?

It is not an intrathecal technique.

Why is "Between the pectoralis major and minor muscles" not the answer?

The plane between pectoralis major and minor is used in the PECS block.

Why is "Into the epidural space" not the answer?

The block is a fascial plane block and not an epidural.

What concept does this question test?

It tests Regional anaesthesia: erector spinae plane block in Anaesthesia. The drug spreads to the dorsal and ventral rami, giving thoracic or abdominal wall analgesia. It is simpler and safer than neuraxial or paravertebral blocks.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Regional anaesthesia: erector spinae plane block?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.