TY  - CHAP
M1  - Book, Section
TI  - Lumbar Plexus Block
A1  - Vloka, Jerry D
A1  - Tsai, Tony
A1  - Hadzic, Admir
A2  - Hadzic, Admir
PY  - 2017
T2  - Hadzic's Textbook of Regional Anesthesia and Acute Pain Management, 2e
AB  - Lumbar  plexus  is  an  advanced  regional  anesthesia  technique,  practiced  by  relatively  few,  experienced  regional  anesthesiologists.  This  is  because  these  techniques  have  been  challenging  to  master  and  resulted  in  frequent  failure.1,2,3  Dogliotti4  pointed  out,  “the  nerve  trunks  of  the  lumbar  plexus  which  run  into  the  inferior  extremity  are  at  a  great  distance  from  each  other,  so  much  so  that  in  order  to  produce  anesthesia,  multiple  procedures  are  necessary  with  separate  injections,  for  each  nerve  trunk.”  Hence,  anesthesiologists  preferred  the  more  time-efficient,  simpler  and  reliable  techniques  of  spinal  or  epidural  anesthesia.  Several  variations  of  the  original  technique  have  been  proposed,  the  main  differences  in  these  various  approaches  being  in  the  level  of  blockade  and  the  distance  from  the  midline  for  the  needle  insertion.4,5,6  However,  given  the  deep  location  of  the  lumbar  plexus,  various  approaches  often  represent  miniscule  technical  variations  rather  than  clinically  relevant  modifications.  For  instance,  Chayen’s  approach  is  thought  to  result  in  too  high  incidence  of  epidural  blockade,7  but  another  proposed  technique  also  resulted  in  a  15%  incidence  of  epidural  blockade.8  Although  ultrasound  guidance  may  allow  visualization  of  the  lumbar  plexus,  the  ultrasound  guided  technique  still  requires  expertise  and  is  technically  challenging;  refer  Chapter  38.9,10,11  Regardless  of  which  technique  is  followed,  certain  safety  precautions  must  be  used  for  successful  and  safe  use  of  this  technique.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/18
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=1141739559
ER  -