Circumpsoas block ... an anterior myofascial plane block for lumbar plexus elements: case report

Diwan, Sandeep; Nair, Abhijit; Gawai, Nitin; Shah, Dipal; Sancheti, Parag

doi:10.1016/j.bjane.2021.04.015

Cited by 3 publications

(4 citation statements)

References 3 publications

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“…Second, the main branches of lumbar plexus, such as LFCN, femoral and obturator nerves, anatomically emerge lateral and medial to PM muscle encased by the TF at variable levels. 4 , 13 , 19 Therefore, the LA injected into the compartment around the anterolateral border of PM muscle at the supra-iliac level may spread caudally and laterally to block the LFCN and the femoral nerves. Finally, the LA injected into the compartment around and posterior to the PM muscle at the L5/S1 level can block the lumbosacral trunk and obturator nerve, since these nerves are located in the same compartment.…”

Section: Discussionmentioning

confidence: 99%

“… 6 , 9 We termed the simple procedures as the circum-psoas blocks, since the LA was placed around the anterolateral and posterior edges of PM muscle at the supra-iliac and L5/S1 levels, respectively. 13 In the current study, we aimed to evaluate the sensory loss obtained by the circum-psoas blocks in patients undergoing total hip replacement.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Sensory Loss Obtained by Circum-Psoas Blocks in Patients Undergoing Total Hip Replacement: A Descriptive Pilot Study

Shi

Shao

et al. 2022

JPR

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Purpose The transversalis fascia (TF) encases the quadratus lumborum and psoas major (PM) muscles, respectively, after they split caudalward approximately at the level of the iliac crest. The branches of the lumbar plexus variably exit medially and laterally from the TF-encased PM muscle. We hypothesized that the local anesthetic (LA) injections around the anterolateral edge of PM at the supra-iliac level and into the retro-psoas compartment at the L5/S1 level, which termed as the circum-psoas blocks, could block the lumbar plexus branches. Therefore, here we evaluated the sensory loss caused by the circum-psoas blocks. Methods A total of 26 patients scheduled for total hip replacement were recruited for the study. After anesthesia induction, the ultrasound-guided circum-psoas blocks were performed in the lateral position with the affected side upward, in which the 0.3% ropivacaine was injected posterior to the TF and around the anterolateral edge of PM muscle at the supra-iliac level (25 mL), and into the retro-psoas compartment at the L5/S1 level (20 mL). The sensory block dermatomes and the muscle strength of quadriceps femoris were evaluated at 2 h or 6 h after surgery, respectively. The postoperative pain scores and opioid consumption were recorded. Results The median (interquartile range) highest and lowest dermatomes of sensory block were T10 (T9–T10) and S2 (S2–S2), respectively. The muscle strength of the quadriceps femoris evaluated at 6 h post-surgery was 4 (4–5) points. Total postoperative equivalent milligrams of oral morphine consumption in the first 24 h were 11.3 ± 3.6 mg. Conclusion The circum-psoas blocks may be a promising approach for postoperative analgesia of hip surgery, since they provide a dermatomal coverage of sensory block from T8–11 to S1–3. Clinical Trial Registration Chinese Clinical Trial Registry, clinical trial number ChiCTR2100051247.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of Sensory Loss Obtained by Circum-Psoas Blocks in Patients Undergoing Total Hip Replacement: A Descriptive Pilot Study

Shi

Shao

et al. 2022

JPR

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“…Several alternative approaches to the suprainguinal fascia iliaca (FI) block,[ 1 ] such as the circumpsoas block and the anterior iliopsoas plane block, targeting the FI compartment in the anterior surface of the psoas major muscle (PMM), have been proposed; nevertheless, the cranial and posterior spread of local anaesthetic may be unpredictable because cranial approaches would impinge on intraabdominal contents. [ 2 ]…”

mentioning

confidence: 99%

“…This approach has a different injection point—more cranial, medial and posterior—from the suprainguinal FI block. [ 1 ] The ultrasound probe is oriented obliquely from the anterior superior iliac spine (ASIS) (1 cm distally and medially) towards the umbilicus [ Figure 1 ]; at L5-S1 level, the iliac bone is seen as a J-shaped hockey stick, instead of a straight line that terminates medially in the vicinity of the medial edge of the iliacus muscle (IM); the FI covers the IM and PMM anteriorly, but not the iliopsoas space[ 2 ]; additionally, an interosseous gap medial to the iliac bone identifies the sacroiliac joint (SIJ) [ Figure 1 ].…”

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confidence: 99%

The novel proximal para-iliopsoas (PPIP) block for hip surgery: A technical report

Almeida¹

2022

Indian J Anaesth

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Circum-Psoas Block versus Supra-Inguinal Fascia Iliaca Block for Postoperative Analgesia in Patients Undergoing Total Hip Arthroplasty: A Randomized Clinical Trial

Zheng,

Mi,

Liang

et al. 2023

JPR

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Circumpsoas block ... an anterior myofascial plane block for lumbar plexus elements: case report

Cited by 3 publications

References 3 publications

Evaluation of Sensory Loss Obtained by Circum-Psoas Blocks in Patients Undergoing Total Hip Replacement: A Descriptive Pilot Study

Evaluation of Sensory Loss Obtained by Circum-Psoas Blocks in Patients Undergoing Total Hip Replacement: A Descriptive Pilot Study

The novel proximal para-iliopsoas (PPIP) block for hip surgery: A technical report

Circum-Psoas Block versus Supra-Inguinal Fascia Iliaca Block for Postoperative Analgesia in Patients Undergoing Total Hip Arthroplasty: A Randomized Clinical Trial

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