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This intervention refers to a specific analgesic combination used by the National Taiwan University Hospital for ultrasound-guided Erector Spinae Plane Block (ESPB). It consists of levobupivacaine (marketed as Chirocaine), a long-acting local anesthetic, and iohexol (marketed as Omnipaque), a non-ionic, water-soluble radiographic contrast medium. Levobupivacaine, the S-enantiomer of bupivacaine, works by binding to the intracellular portion of voltage-gated sodium channels, blocking the influx of sodium ions into nerve cells and preventing the depolarization and propagation of pain signals. Iohexol is added to the mixture to allow for the visualization of the local anesthetic's spread within the fascial plane under imaging. This combination is primarily investigated for providing postoperative analgesia in patients undergoing radiofrequency ablation for hepatocellular carcinoma.
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