{
  "abstract": "Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission Application for ESRA Abstract Prizes: I apply as an Anesthesiologist (Aged 35 years old or less)Background and Aims Mine-blast injuries from warfare in Ukraine present complex challenges in perioperative pain management. We report a case of a 39-year-old male who sustained a mine-blast injury to the left scapula and proximal humerus during combat operations, resulting in severe soft tissue damage and persistent pain during wound management and surgical interventions.Methods The patient underwent multiple surgical debridements and vacuum-assisted closure (VAC) therapy. Due to intense pain (NRS 7–8 points) unrelieved by systemic analgesics, a multimodal regional anesthesia approach was employed. Two tunneled catheters were placed: one for an erector spinae plane (ESP) block at the T5 level and another via the interscalene approach to the brachial plexus. Continuous infusion of 0.25% bupivacaine at 6 mL/hour was administered through each catheter. During surgical debridements, additional boluses of 50 mg bupivacaine were provided, along with midazolam sedation titrated to RASS -2 for optimal patient comfort and cooperation.Results This combination of regional blocks provided effective analgesia, enabling tolerance of wound care procedures and reducing systemic opioid requirements. On postoperative day 7, both catheters were removed due to displacement. In the subsequent period, the patient required only intermittent single-shot nerve blocks for adequate pain control.Abstract P212 Figure 1Injuries during surgical treatmentConclusions This case illustrates the feasibility and efficacy of combining prolonged ESP and interscalene catheter-based regional anesthesia for complex blast injuries involving the shoulder girdle. Such techniques offer significant analgesic benefits, minimize opioid use, and enhance patient outcomes in austere and military trauma care settings. Further research is needed to establish standardized protocols for prolonged regional analgesia in battlefield-related injuries.",
  "authors": [
    {
      "affiliations": [
        "Chair of the Surgery, Anesthesiology and Intensive Therapy, Bogomolets National Medical University, Kyiv, Ukraine"
      ],
      "name": "Natalia Semenko"
    },
    {
      "affiliations": [
        "Chair of the Surgery, Anesthesiology and Intensive Therapy, Bogomolets National Medical University, Kyiv, Ukraine"
      ],
      "name": "Frank Michael"
    },
    {
      "affiliations": [
        "Chair of the Surgery, Anesthesiology and Intensive Therapy, Bogomolets National Medical University, Kyiv, Ukraine"
      ],
      "name": "Kuchyn Iurii"
    },
    {
      "affiliations": [
        "Chair of the Surgery, Anesthesiology and Intensive Therapy, Bogomolets National Medical University, Kyiv, Ukraine"
      ],
      "name": "Bielka Kateryna"
    }
  ],
  "title": "P212 Perioperative pain management in a patient with mine-blast injury to the shoulder and scapular region using combined prolonged regional analgesia techniques: a case report",
  "uid": "add45c53-ffeb-5505-a7c7-297feed54674"
}