TY - CHAP M1 - Book, Section TI - Chapter 46. Ultrasound of the Lumbar Paravertebral Space and Considerations for Lumbar Plexus Block A1 - Karmakar, Manoj A1 - Vandepitte, Catherine A2 - Hadzic, Admir PY - 2012 T2 - Hadzic's Peripheral Nerve Blocks and Anatomy for Ultrasound-Guided Regional Anesthesia, 2e AB - Lumbar plexus block (LPB) traditionally is performed using surface anatomic landmarks to identify the site for needle insertion and eliciting quadriceps muscle contraction in response to nerve electro-localization, as described in the nerve stimulator–guided chapter. The main challenges in accomplishing LPB relate to the depth at which the lumbar plexus is located and the size of the plexus, which requires a large volume of local anesthetic for success. Due to the deep anatomic location of the lumbar plexus, small errors in landmark estimation or angle miscalculations during needle advancement can result in needle placement away from the plexus or at unwanted locations. Therefore, monitoring of the needle path and final needle tip placement should increase the precision of the needle placement and the delivery of the local anesthetic. Although computed tomography and fluoroscopy can be used to increase the precision during LPB, these technologies are impractical in the busy operating room environment, costly, and associated with radiation exposure. It is only logical, then, that ultrasound-guided LPB is of interest because of the ever-increasing availability of portable machines and the improvement in the quality of the images obtained.1,2 SN - PB - The McGraw-Hill Companies CY - New York, NY Y2 - 2024/04/24 UR - accessanesthesiology.mhmedical.com/content.aspx?aid=55905181 ER -