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Daqiang Zhao - One of the best experts on this subject based on the ideXlab platform.
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Ultrasound-guided anterior iliopsoas muscle space Block versus posterior Lumbar Plexus Block in hip surgery in the elderly: A randomised controlled trial.
European journal of anaesthesiology, 2021Co-Authors: Jing Dong, Yu Zhang, Xiaoxiao Chen, Hai Yan, Yupu Liu, Haibo Shi, Wei Jiang, Daqiang ZhaoAbstract:Ultrasound-guided posterior Lumbar Plexus Block is widely used for hip fracture surgery but it requires a change of position, which may be painful. Our primary objective was to describe a new technique, the anterior iliopsoas muscle space Block, which can be performed in the supine position, and to test the hypothesis that its analgesia for hip surgery was similar to that of the traditional posterior Lumbar Plexus Block. Randomised, double-blind study. Shanghai 6th People's Hospital, China, from February to August 2019. Forty-eight patients scheduled for unilateral hip fracture surgery were included in the study. The exclusion criteria were infection at the puncture site, history of hip surgery, pre-existing neurological deficits of the lower extremity, contraindications for regional anaesthesia, allergy to local anaesthetics, coagulopathy, abuse of medicine or alcohol, or daily consumption of analgesics. Patients were randomised to receive a lateral sacral Plexus Block with either an anterior iliopsoas muscle space Block or a posterior Lumbar Plexus Block, using 0.33% ropivacaine (30 ml each). The main outcome was verbal numerical scale (VNS) pain intensity 1 h after surgery in the postanesthesia care unit, and the secondary outcome was the dose of intra-operative fentanyl. The differences in VNS scores and fentanyl use between the groups were analysed. Based on previous work, we considered a difference (confidence interval [CI]) of 1.6 on the VNS to be significant. The median [IQR] pain scores in postanesthesia care unit were similar in the anterior 0 [0 to 3] and posterior groups 1.5 [0 to 3]. The median scores for intra-operative fentanyl use were similar in the anterior 20 [10 to 42.5] μg and posterior groups 15 [0 to 50] μg (P = 0.34). The difference in the median pain score at-rest was NS: anterior group 0.5 [0 to 5], posterior group 0 [0 to 2], median difference -0.5 (95% CI -2 to 0). The median post to preBlock difference in VNS was higher in the anterior -0.5 [-2 to 0] than in the posterior group 0 [-1.25 to 0], median difference 0.5 (95% CI 0 to 1). The median Block onset time was longer in the anterior 11 [6 to 14.25] min than in the posterior group 6 [4.75 to 8] min (P = 0.002), median difference -5 (95% CI -7 to -1). The anterior iliopsoas muscle space Block had the same effect as the posterior Lumbar Plexus Block on peri-operative analgesia for hip surgery, but with a longer onset time. Therefore, anterior iliopsoas muscle space Block can be recommended as a routine technique for hip and lower limb procedures. http://www.chictr.org.cn identifier: ChiCTR1900021214. Copyright © 2021 European Society of Anaesthesiology.
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ultrasound guided anterior iliopsoas muscle space Block versus posterior Lumbar Plexus Block in hip surgery in the elderly a randomised controlled trial
European Journal of Anaesthesiology, 2021Co-Authors: Jing Dong, Yu Zhang, Xiaoxiao Chen, Hai Yan, Yupu Liu, Haibo Shi, Wei Jiang, Daqiang ZhaoAbstract:BACKGROUND Ultrasound-guided posterior Lumbar Plexus Block is widely used for hip fracture surgery but it requires a change of position, which may be painful. OBJECTIVES Our primary objective was to describe a new technique, the anterior iliopsoas muscle space Block, which can be performed in the supine position, and to test the hypothesis that its analgesia for hip surgery was similar to that of the traditional posterior Lumbar Plexus Block. DESIGN Randomised, double-blind study. SETTING Shanghai 6th People's Hospital, China, from February to August 2019. PATIENTS Forty-eight patients scheduled for unilateral hip fracture surgery were included in the study. The exclusion criteria were infection at the puncture site, history of hip surgery, pre-existing neurological deficits of the lower extremity, contraindications for regional anaesthesia, allergy to local anaesthetics, coagulopathy, abuse of medicine or alcohol, or daily consumption of analgesics. INTERVENTIONS Patients were randomised to receive a lateral sacral Plexus Block with either an anterior iliopsoas muscle space Block or a posterior Lumbar Plexus Block, using 0.33% ropivacaine (30 ml each). MAIN OUTCOME MEASURES The main outcome was verbal numerical scale (VNS) pain intensity 1 h after surgery in the postanesthesia care unit, and the secondary outcome was the dose of intra-operative fentanyl. The differences in VNS scores and fentanyl use between the groups were analysed. RESULTS Based on previous work, we considered a difference (confidence interval [CI]) of 1.6 on the VNS to be significant. The median [IQR] pain scores in postanesthesia care unit were similar in the anterior 0 [0 to 3] and posterior groups 1.5 [0 to 3]. The median scores for intra-operative fentanyl use were similar in the anterior 20 [10 to 42.5] μg and posterior groups 15 [0 to 50] μg (P = 0.34). The difference in the median pain score at-rest was NS: anterior group 0.5 [0 to 5], posterior group 0 [0 to 2], median difference -0.5 (95% CI -2 to 0). The median post to preBlock difference in VNS was higher in the anterior -0.5 [-2 to 0] than in the posterior group 0 [-1.25 to 0], median difference 0.5 (95% CI 0 to 1). The median Block onset time was longer in the anterior 11 [6 to 14.25] min than in the posterior group 6 [4.75 to 8] min (P = 0.002), median difference -5 (95% CI -7 to -1). CONCLUSION The anterior iliopsoas muscle space Block had the same effect as the posterior Lumbar Plexus Block on peri-operative analgesia for hip surgery, but with a longer onset time. Therefore, anterior iliopsoas muscle space Block can be recommended as a routine technique for hip and lower limb procedures. TRIAL REGISTRATION http://www.chictr.org.cn identifier: ChiCTR1900021214.
Jing Dong - One of the best experts on this subject based on the ideXlab platform.
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Ultrasound-guided anterior iliopsoas muscle space Block versus posterior Lumbar Plexus Block in hip surgery in the elderly: A randomised controlled trial.
European journal of anaesthesiology, 2021Co-Authors: Jing Dong, Yu Zhang, Xiaoxiao Chen, Hai Yan, Yupu Liu, Haibo Shi, Wei Jiang, Daqiang ZhaoAbstract:Ultrasound-guided posterior Lumbar Plexus Block is widely used for hip fracture surgery but it requires a change of position, which may be painful. Our primary objective was to describe a new technique, the anterior iliopsoas muscle space Block, which can be performed in the supine position, and to test the hypothesis that its analgesia for hip surgery was similar to that of the traditional posterior Lumbar Plexus Block. Randomised, double-blind study. Shanghai 6th People's Hospital, China, from February to August 2019. Forty-eight patients scheduled for unilateral hip fracture surgery were included in the study. The exclusion criteria were infection at the puncture site, history of hip surgery, pre-existing neurological deficits of the lower extremity, contraindications for regional anaesthesia, allergy to local anaesthetics, coagulopathy, abuse of medicine or alcohol, or daily consumption of analgesics. Patients were randomised to receive a lateral sacral Plexus Block with either an anterior iliopsoas muscle space Block or a posterior Lumbar Plexus Block, using 0.33% ropivacaine (30 ml each). The main outcome was verbal numerical scale (VNS) pain intensity 1 h after surgery in the postanesthesia care unit, and the secondary outcome was the dose of intra-operative fentanyl. The differences in VNS scores and fentanyl use between the groups were analysed. Based on previous work, we considered a difference (confidence interval [CI]) of 1.6 on the VNS to be significant. The median [IQR] pain scores in postanesthesia care unit were similar in the anterior 0 [0 to 3] and posterior groups 1.5 [0 to 3]. The median scores for intra-operative fentanyl use were similar in the anterior 20 [10 to 42.5] μg and posterior groups 15 [0 to 50] μg (P = 0.34). The difference in the median pain score at-rest was NS: anterior group 0.5 [0 to 5], posterior group 0 [0 to 2], median difference -0.5 (95% CI -2 to 0). The median post to preBlock difference in VNS was higher in the anterior -0.5 [-2 to 0] than in the posterior group 0 [-1.25 to 0], median difference 0.5 (95% CI 0 to 1). The median Block onset time was longer in the anterior 11 [6 to 14.25] min than in the posterior group 6 [4.75 to 8] min (P = 0.002), median difference -5 (95% CI -7 to -1). The anterior iliopsoas muscle space Block had the same effect as the posterior Lumbar Plexus Block on peri-operative analgesia for hip surgery, but with a longer onset time. Therefore, anterior iliopsoas muscle space Block can be recommended as a routine technique for hip and lower limb procedures. http://www.chictr.org.cn identifier: ChiCTR1900021214. Copyright © 2021 European Society of Anaesthesiology.
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ultrasound guided anterior iliopsoas muscle space Block versus posterior Lumbar Plexus Block in hip surgery in the elderly a randomised controlled trial
European Journal of Anaesthesiology, 2021Co-Authors: Jing Dong, Yu Zhang, Xiaoxiao Chen, Hai Yan, Yupu Liu, Haibo Shi, Wei Jiang, Daqiang ZhaoAbstract:BACKGROUND Ultrasound-guided posterior Lumbar Plexus Block is widely used for hip fracture surgery but it requires a change of position, which may be painful. OBJECTIVES Our primary objective was to describe a new technique, the anterior iliopsoas muscle space Block, which can be performed in the supine position, and to test the hypothesis that its analgesia for hip surgery was similar to that of the traditional posterior Lumbar Plexus Block. DESIGN Randomised, double-blind study. SETTING Shanghai 6th People's Hospital, China, from February to August 2019. PATIENTS Forty-eight patients scheduled for unilateral hip fracture surgery were included in the study. The exclusion criteria were infection at the puncture site, history of hip surgery, pre-existing neurological deficits of the lower extremity, contraindications for regional anaesthesia, allergy to local anaesthetics, coagulopathy, abuse of medicine or alcohol, or daily consumption of analgesics. INTERVENTIONS Patients were randomised to receive a lateral sacral Plexus Block with either an anterior iliopsoas muscle space Block or a posterior Lumbar Plexus Block, using 0.33% ropivacaine (30 ml each). MAIN OUTCOME MEASURES The main outcome was verbal numerical scale (VNS) pain intensity 1 h after surgery in the postanesthesia care unit, and the secondary outcome was the dose of intra-operative fentanyl. The differences in VNS scores and fentanyl use between the groups were analysed. RESULTS Based on previous work, we considered a difference (confidence interval [CI]) of 1.6 on the VNS to be significant. The median [IQR] pain scores in postanesthesia care unit were similar in the anterior 0 [0 to 3] and posterior groups 1.5 [0 to 3]. The median scores for intra-operative fentanyl use were similar in the anterior 20 [10 to 42.5] μg and posterior groups 15 [0 to 50] μg (P = 0.34). The difference in the median pain score at-rest was NS: anterior group 0.5 [0 to 5], posterior group 0 [0 to 2], median difference -0.5 (95% CI -2 to 0). The median post to preBlock difference in VNS was higher in the anterior -0.5 [-2 to 0] than in the posterior group 0 [-1.25 to 0], median difference 0.5 (95% CI 0 to 1). The median Block onset time was longer in the anterior 11 [6 to 14.25] min than in the posterior group 6 [4.75 to 8] min (P = 0.002), median difference -5 (95% CI -7 to -1). CONCLUSION The anterior iliopsoas muscle space Block had the same effect as the posterior Lumbar Plexus Block on peri-operative analgesia for hip surgery, but with a longer onset time. Therefore, anterior iliopsoas muscle space Block can be recommended as a routine technique for hip and lower limb procedures. TRIAL REGISTRATION http://www.chictr.org.cn identifier: ChiCTR1900021214.
Jeanmarc Malinovsky - One of the best experts on this subject based on the ideXlab platform.
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successful resuscitation after ropivacaine and lidocaine induced ventricular arrhythmia following posterior Lumbar Plexus Block in a child
Anesthesia & Analgesia, 2008Co-Authors: H Ludot, Jeanyves Tharin, Mohamed Belouadah, Jeanxavier Mazoit, Jeanmarc MalinovskyAbstract:We report the case of a 13-yr-old girl scheduled for knee surgery under general anesthesia and posterior Lumbar Plexus Block. A ventricular arrhythmia developed 15 min after local anesthetic injection. A 20% lipid emulsion was successful in converting the ventricular arrhythmia to a sinus rhythm. Th
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successful resuscitation after ropivacaine and lidocaine induced ventricular arrhythmia following posterior Lumbar Plexus Block in a child
Anesthesia & Analgesia, 2008Co-Authors: H Ludot, Jeanyves Tharin, Mohamed Belouadah, Jeanxavier Mazoit, Jeanmarc MalinovskyAbstract:We report the case of a 13-yr-old girl scheduled for knee surgery under general anesthesia and posterior Lumbar Plexus Block. A ventricular arrhythmia developed 15 min after local anesthetic injection. A 20% lipid emulsion was successful in converting the ventricular arrhythmia to a sinus rhythm. This is consistent with previous reports suggesting that lipid emulsion is an effective emergency treatment of local anesthetic toxicity. We recommend the immediate availability of lipid emulsion along with other emergency therapeutics in operating rooms where local anesthetics are used.
Yu Zhang - One of the best experts on this subject based on the ideXlab platform.
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Ultrasound-guided anterior iliopsoas muscle space Block versus posterior Lumbar Plexus Block in hip surgery in the elderly: A randomised controlled trial.
European journal of anaesthesiology, 2021Co-Authors: Jing Dong, Yu Zhang, Xiaoxiao Chen, Hai Yan, Yupu Liu, Haibo Shi, Wei Jiang, Daqiang ZhaoAbstract:Ultrasound-guided posterior Lumbar Plexus Block is widely used for hip fracture surgery but it requires a change of position, which may be painful. Our primary objective was to describe a new technique, the anterior iliopsoas muscle space Block, which can be performed in the supine position, and to test the hypothesis that its analgesia for hip surgery was similar to that of the traditional posterior Lumbar Plexus Block. Randomised, double-blind study. Shanghai 6th People's Hospital, China, from February to August 2019. Forty-eight patients scheduled for unilateral hip fracture surgery were included in the study. The exclusion criteria were infection at the puncture site, history of hip surgery, pre-existing neurological deficits of the lower extremity, contraindications for regional anaesthesia, allergy to local anaesthetics, coagulopathy, abuse of medicine or alcohol, or daily consumption of analgesics. Patients were randomised to receive a lateral sacral Plexus Block with either an anterior iliopsoas muscle space Block or a posterior Lumbar Plexus Block, using 0.33% ropivacaine (30 ml each). The main outcome was verbal numerical scale (VNS) pain intensity 1 h after surgery in the postanesthesia care unit, and the secondary outcome was the dose of intra-operative fentanyl. The differences in VNS scores and fentanyl use between the groups were analysed. Based on previous work, we considered a difference (confidence interval [CI]) of 1.6 on the VNS to be significant. The median [IQR] pain scores in postanesthesia care unit were similar in the anterior 0 [0 to 3] and posterior groups 1.5 [0 to 3]. The median scores for intra-operative fentanyl use were similar in the anterior 20 [10 to 42.5] μg and posterior groups 15 [0 to 50] μg (P = 0.34). The difference in the median pain score at-rest was NS: anterior group 0.5 [0 to 5], posterior group 0 [0 to 2], median difference -0.5 (95% CI -2 to 0). The median post to preBlock difference in VNS was higher in the anterior -0.5 [-2 to 0] than in the posterior group 0 [-1.25 to 0], median difference 0.5 (95% CI 0 to 1). The median Block onset time was longer in the anterior 11 [6 to 14.25] min than in the posterior group 6 [4.75 to 8] min (P = 0.002), median difference -5 (95% CI -7 to -1). The anterior iliopsoas muscle space Block had the same effect as the posterior Lumbar Plexus Block on peri-operative analgesia for hip surgery, but with a longer onset time. Therefore, anterior iliopsoas muscle space Block can be recommended as a routine technique for hip and lower limb procedures. http://www.chictr.org.cn identifier: ChiCTR1900021214. Copyright © 2021 European Society of Anaesthesiology.
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ultrasound guided anterior iliopsoas muscle space Block versus posterior Lumbar Plexus Block in hip surgery in the elderly a randomised controlled trial
European Journal of Anaesthesiology, 2021Co-Authors: Jing Dong, Yu Zhang, Xiaoxiao Chen, Hai Yan, Yupu Liu, Haibo Shi, Wei Jiang, Daqiang ZhaoAbstract:BACKGROUND Ultrasound-guided posterior Lumbar Plexus Block is widely used for hip fracture surgery but it requires a change of position, which may be painful. OBJECTIVES Our primary objective was to describe a new technique, the anterior iliopsoas muscle space Block, which can be performed in the supine position, and to test the hypothesis that its analgesia for hip surgery was similar to that of the traditional posterior Lumbar Plexus Block. DESIGN Randomised, double-blind study. SETTING Shanghai 6th People's Hospital, China, from February to August 2019. PATIENTS Forty-eight patients scheduled for unilateral hip fracture surgery were included in the study. The exclusion criteria were infection at the puncture site, history of hip surgery, pre-existing neurological deficits of the lower extremity, contraindications for regional anaesthesia, allergy to local anaesthetics, coagulopathy, abuse of medicine or alcohol, or daily consumption of analgesics. INTERVENTIONS Patients were randomised to receive a lateral sacral Plexus Block with either an anterior iliopsoas muscle space Block or a posterior Lumbar Plexus Block, using 0.33% ropivacaine (30 ml each). MAIN OUTCOME MEASURES The main outcome was verbal numerical scale (VNS) pain intensity 1 h after surgery in the postanesthesia care unit, and the secondary outcome was the dose of intra-operative fentanyl. The differences in VNS scores and fentanyl use between the groups were analysed. RESULTS Based on previous work, we considered a difference (confidence interval [CI]) of 1.6 on the VNS to be significant. The median [IQR] pain scores in postanesthesia care unit were similar in the anterior 0 [0 to 3] and posterior groups 1.5 [0 to 3]. The median scores for intra-operative fentanyl use were similar in the anterior 20 [10 to 42.5] μg and posterior groups 15 [0 to 50] μg (P = 0.34). The difference in the median pain score at-rest was NS: anterior group 0.5 [0 to 5], posterior group 0 [0 to 2], median difference -0.5 (95% CI -2 to 0). The median post to preBlock difference in VNS was higher in the anterior -0.5 [-2 to 0] than in the posterior group 0 [-1.25 to 0], median difference 0.5 (95% CI 0 to 1). The median Block onset time was longer in the anterior 11 [6 to 14.25] min than in the posterior group 6 [4.75 to 8] min (P = 0.002), median difference -5 (95% CI -7 to -1). CONCLUSION The anterior iliopsoas muscle space Block had the same effect as the posterior Lumbar Plexus Block on peri-operative analgesia for hip surgery, but with a longer onset time. Therefore, anterior iliopsoas muscle space Block can be recommended as a routine technique for hip and lower limb procedures. TRIAL REGISTRATION http://www.chictr.org.cn identifier: ChiCTR1900021214.
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Effect of ultrasound-guided Lumbar Plexus Block on emergence agitation in children undergoing hip surgery: study protocol for a randomized controlled trial.
Trials, 2019Co-Authors: Hui Zhang, Qing Fan, Junfeng Zhang, Xiaofeng Wang, Yu Zhang, Aizhong WangAbstract:Background Emergence agitation (EA) is a common postoperative issue in children that causes self-injury, increases stress on healthcare team members, and even leads to postoperative maladaptive behavioral changes in children. Clear answers regarding a ‘gold standard’ for prevention of EA are not available. Pain is regarded as an important causative factor of EA, and ultrasound-guided Lumbar Plexus Block is a safe and efficient anesthetic method that can provide satisfactory pain relief in pediatric hip surgery. The purpose of our study is to determine whether ultrasound-guided Lumbar Plexus Block can reduce the incidence of EA in children undergoing hip surgery.
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Effect of ultrasound-guided Lumbar Plexus Block on emergence agitation in children undergoing hip surgery: study protocol for a randomized controlled trial
BMC, 2019Co-Authors: Hui Zhang, Qing Fan, Junfeng Zhang, Xiaofeng Wang, Yu Zhang, Aizhong WangAbstract:Abstract Background Emergence agitation (EA) is a common postoperative issue in children that causes self-injury, increases stress on healthcare team members, and even leads to postoperative maladaptive behavioral changes in children. Clear answers regarding a ‘gold standard’ for prevention of EA are not available. Pain is regarded as an important causative factor of EA, and ultrasound-guided Lumbar Plexus Block is a safe and efficient anesthetic method that can provide satisfactory pain relief in pediatric hip surgery. The purpose of our study is to determine whether ultrasound-guided Lumbar Plexus Block can reduce the incidence of EA in children undergoing hip surgery. Methods/design We designed a prospective, randomized, controlled, blinded trial to determine the effect of ultrasound-guided Lumbar Plexus Block on EA. A total of 100 American Society of Anesthesiologists class I–II children (1–6 years old) scheduled for elective hip surgery will be recruited for this study. Participants will be randomized at a 1:1 ratio to receive either ultrasound-guided Lumbar Plexus Block or fentanyl after the induction of general anesthesia. The primary outcome is the incidence of EA 30 min after emergence from anesthesia using the Pediatric Anesthesia Emergence Delirium (PAED) score. The secondary outcomes are the severity and duration of EA 30 min after emergence from anesthesia using the PAED score, postoperative pain evaluated by the Children’s Hospital of Eastern Ontario Pain Scale, and the incidence of postoperative adverse events. Randomization will be conducted using a computer-generated randomization schedule. Outcome assessors and data collectors will be blinded to the group allocations. Assessments will be performed before surgery, intraoperatively, and postoperatively at every time point. Discussion Our hypothesis in this trial is that ultrasound-guided Lumbar Plexus Block can decrease the incidence of EA in children undergoing elective hip surgery. This trial will provide clinical answers to verify our hypothesis. If our hypothesis is confirmed, the results could provide a safe method to prevent EA. Trial registration Chinese Clinical Trial Registry, ChiCTR-INR-17011525. Registered on 30 May 2017
Manoj K Karmakar - One of the best experts on this subject based on the ideXlab platform.
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Ultrasound visualization of the anatomy relevant for Lumbar Plexus Block: comparison of the paramedian transverse and Shamrock scan technique
Regional anesthesia and pain medicine, 2019Co-Authors: Pawinee Pangthipampai, Suwimon Tangwiwat, Jatuporn Pakpirom, Banchobporn Songthamwat, Manoj K KarmakarAbstract:Ultrasound-guided (USG) Lumbar Plexus Block (LPB) is considered an advanced regional anesthetic technique[1][1] because the Plexus is located at a depth[2][2] and ultrasound visualization of the anatomy can be difficult.[3–5][3] Several different techniques have been described for USG LPB,[3 4 6][
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Case report Ultrasound-guided Lumbar Plexus Block through the acoustic window of the Lumbar ultrasound trident
2015Co-Authors: Manoj K Karmakar, Wing H Kwok, K Tsang, W. Ngan D. KeeAbstract:Lumbar Plexus Block (LPB) is frequently used in combination with an ipsilateral sacral Plexus or sciatic nerve Block for lower limb surgery. This is traditionally performed using surface ana-tomical landmarks, and the site for local anaesthetic injection is confirmed by observing quadriceps muscle contraction to peripheral nerve stimulation. In this report, we describe a technique of ultrasound-guided LPB that was successfully used, in conjunction with a sciatic nerve Block, for anaesthesia during emergency lower limb surgery. The anatomy, sonographic features, technique of identifying the Lumbar Plexus, and the potential benefits of using this approach are discussed
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Sonoanatomy relevant for Lumbar Plexus Block in volunteers correlated with cross-sectional anatomic and magnetic resonance images.
Regional anesthesia and pain medicine, 2013Co-Authors: Manoj K Karmakar, H. Kwok, Edmund Soh, Admir HadzicAbstract:Background Ultrasound imaging of the anatomy relevant for Lumbar Plexus Block (LPB) is challenging because of its deep anatomic location and the “acoustic shadow” of the overlying transverse processes. A paramedian transverse scan (PMTS) of the Lumbar paravertebral region with the ultrasound beam being insonated through the intertransverse space (ITS) and directed medially toward the intervertebral foramen (PMTS-ITS) may overcome the problem of the “acoustic shadow” and allow clear visualization of the anatomy relevant for LPB. This study assessed the feasibility of using PMTS-ITS for imaging the anatomy relevant for LPB in healthy volunteers. Methods Thirty young volunteers underwent a PMTS-ITS of the right Lumbar paravertebral region. The sonoanatomy was defined in corresponding cadaver anatomic sections and magnetic resonance images. Visibility of the paravertebral structures in the sonograms was assessed by 4 independent observers using a 4-point Likert scale (0, not visible; 1, hardly visible; 2, well visible; 3, very well visible), and the mean total ultrasound visibility score (UVS; maximum score possible, 30) was determined. Overall ultrasound visibility was judged as good if the total UVS was greater than 20, average if it was 10 to 20, and poor if it was less than 10. Results Ultrasound imaging of the right Lumbar paravertebral region at the L3-L4-L5 vertebral level was successfully performed through the PMTS-ITS scan window in all volunteers studied. The Lumbar nerve root, Lumbar paravertebral space, Lumbar Plexus, and the psoas compartment were delineated in 57%, 27%, 57%, and 87% of volunteers, respectively. Overall ultrasound visibility of the Lumbar paravertebral structures was judged as “good” (mean [SD] total UVS, 20.4 [3]). Conclusions A PMTS-ITS can be used to image the sonoanatomy relevant for LPB including the Lumbar nerve root, Lumbar paravertebral space, Lumbar Plexus, and the psoas compartment.
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ultrasound guided Lumbar Plexus Block through the acoustic window of the Lumbar ultrasound trident
BJA: British Journal of Anaesthesia, 2008Co-Authors: Manoj K Karmakar, A M H Ho, Wing H Kwok, Xiang Li, K TsangAbstract:Abstract Lumbar Plexus Block (LPB) is frequently used in combination with an ipsilateral sacral Plexus or sciatic nerve Block for lower limb surgery. This is traditionally performed using surface anatomical landmarks, and the site for local anaesthetic injection is confirmed by observing quadriceps muscle contraction to peripheral nerve stimulation. In this report, we describe a technique of ultrasound-guided LPB that was successfully used, in conjunction with a sciatic nerve Block, for anaesthesia during emergency lower limb surgery. The anatomy, sonographic features, technique of identifying the Lumbar Plexus, and the potential benefits of using this approach are discussed.
