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Management of cannabinoid hyperemesis syndrome with an erector spinae plane block in the emergency department

Year: 2025

Type: article

Abstract: Cannabinoid hyperemesis syndrome (CHS) is characterized by recurrent nausea, vomiting, and abdominal pain among patients with chronic cannabis use. Emergency department (ED) management is often difficult, as conventional analgesics and antiemetics are frequently ineffective. We describe a case of refractory CHS successfully managed in the ED with a thoracic erector spinae plane block (ESPB). Following the block, the patient had complete symptom relief and was able to be discharged from the ED, avoiding the need for hospital admission for symptom control. Through blockade of sympathetic visceral nociceptive and emetic signaling, the ESPB may be an effective ED treatment for select cases of CHS.

Source: The American Journal of Emergency Medicine

DOI: 10.1016/j.ajem.2025.11.023

Authors: Richard J. Gawel, Emily Ho, Michael Gottlieb, Jeffrey A. Kramer, Michael Shalaby

Institutions: Hospital of the University of Pennsylvania, University of Pennsylvania, Rush University Medical Center

Language: English

Topic: Anesthesia and Pain Management

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,980