RT Book, Section
A1 Karmakar, Manoj K.
A1 Soh, Edmund
A1 Chee, Victor
A1 Sheah, Kenneth
SR Print(0)
ID 1146855092
T1 Sonoanatomy Relevant for Ultrasound-Guided Lumbar Plexus Block
T2 Atlas of Sonoanatomy for Regional Anesthesia and Pain Medicine
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9780071789349
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1146855092
RD 2024/04/18
AB Lumbar  plexus  block  (LPB),1,2  also  referred  to  as  a  psoas  compartment  block  (PCB),3,4  is  frequently  used  on  its  own  or  in  combination  with  a  sciatic  nerve  block  for  anesthesia  and/or  analgesia  during  hip  or  lower  extremity  surgery.1,3,5,6  During  an  LPB  the  local  anesthetic  is  injected  into  a  fascial  plane  within  the  posterior  aspect  of  the  psoas  muscle.7  This  produces  complete  blockade  of  the  major  components  of  the  ipsilateral  lumbar  plexus,  namely  the  femoral  nerve  (FN),  lateral  femoral  cutaneous  nerve  (LFC),  and  the  obturator  nerve  (OBN).8  The  term  PCB  was  originally  coined  by  Chayen  and  colleagues.4  They  believed  that  branches  of  the  lumbar  plexus  and  parts  of  the  sacral  plexus  were  located  close  to  each  other  in  a  “compartment,”  between  the  psoas  and  quadratus  lumborum  muscle  (an  “intermuscular  compartment”)  at  the  level  of  the  L4  vertebra,  which  could  be  identified  using  a  “loss  of  resistance”  technique.4  However,  recent  research  has  demonstrated  that  the  lumbar  plexus  is  located  within  the  substance  of  the  psoas  muscle.7  PCB  is  also  referred  to  as  posterior  lumbar  plexus  block,1  and  several  variations  of  this  technique  have  been  described  in  the  literature.2,3  LPB  is  traditionally  performed  using  peripheral  nerve  stimulation,8  but  with  the  recent  widespread  use  of  ultrasound  guidance  for  regional  anesthesia  ultrasound-guided  (USG)  LPB  has  also  been  described.9,10  A  clear  understanding  of  the  sonoanatomy  of  the  lumbar  paravertebral  region9–11  is  a  prerequisite  to  safely  performing  USG  LPB.9,10