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Background and Aims Minimally invasive and robotic-assisted cardiac surgery has enabled faster recovery and fewer complications. However, the thoracic access used can cause significant postoperative pain, representing a challenge for anesthetic management. The erector spinae plane (ESP) block is a promising regional technique for thoracic analgesia. This case describes the use of a continuous ESP block via catheter for postoperative pain control in a patient undergoing robotic atrial septal defect (ASD) repair.Methods A 43-year-old female with multiple congenital ASDs and recent cerebellar ischemic stroke due to cardioembolic etiology was scheduled for urgent robotic repair. She was on rivaroxaban preoperatively. Total intravenous anesthesia was performed using propofol, remifentanil, and dexmedetomidine, after induction with sufentanil, etomidate, and rocuronium. A unilateral ESP block was performed at T5 under ultrasound guidance, with catheter placement for continuous analgesia. Cerebral oximetry (Hemosphere) was used during cardiopulmonary bypass. Postoperative analgesia was maintained with intermittent boluses of 0.2% ropivacaine for four days.Results Surgery lasted 120 minutes without complications. The patient was extubated in the operating room and transferred to the ICU. Pain was well controlled with scores between 0 and 1, and no systemic opioids were required. A single bolus was administered on postoperative day two. The catheter was removed on day four, and the patient was discharged from the ICU on day three without adverse events.Conclusions Continuous ESP block proved to be a safe and efficient analgesic strategy in a patient undergoing robotic cardiac surgery. This technique allowed for excellent pain control, minimized opioid use, and promoted early recovery. The use of regional analgesia with continuous catheter infusion should be considered in enhanced recovery protocols for minimally invasive cardiac procedures.