Ultrasound image of lumbar erector spinae plane block. LD = latissimus dorsi; ESM = erector spinae muscle; LA = local anesthetic; L1 = lumbar transverse process; L2 = lumbar transverse process; PM = psoas muscle. The white arrow indicates needle placement using an out-of-plane technique. The local anesthesia is injected just below the erector spinae muscle and above the transverse process of the targeted vertebral body.