Lumbar Plexus in Children

Kirchmair, Lukas; Enna, Birgit; Mitterschiffthaler, G.; Moriggl, Bernhard; Greher, Manfred; Marhofer, Peter; Kapral, Stephan; Gaßner, Ingmar

doi:10.1097/00000542-200408000-00026

Cited by 85 publications

(3 citation statements)

References 12 publications

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“…[ 20 21 ] To decrease the incidence of these complications associated with lumbar plexus block, ultrasound guidance has been introduced which allows direct visualization of the needle, anatomy, neural structures, and the spread of local anesthetics. [ 26 27 ]…”

Section: Discussionmentioning

confidence: 99%

Real-time ultrasound-guided comparison of adductor canal block and psoas compartment block combined with sciatic nerve block in laparoscopic knee surgeries

Messeha

2016

Anesth Essays Res

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Background:Lumbar plexus block, combined with a sciatic nerve block, is an effective locoregional anesthetic technique for analgesia and anesthesia of the lower extremity. The aim of this study was to compare the clinical results outcome of the adductor canal block versus the psoas compartment block combined with sciatic nerve block using real time ultrasound guidance in patients undergoing elective laparoscopic knee surgeries.Patients and Methods:Ninety patients who were undergoing elective laparoscopic knee surgeries were randomly allocated to receive a sciatic nerve block in addition to lumbar plexus block using either an adductor canal block (ACB) or a posterior psoas compartment approach (PCB) using 25 ml of bupivacine 0.5% with adrenaline 1:400,000 injection over 2-3 minutes while observing the distribution of the local anesthetic in real time. Successful nerve block was defined as a complete loss of pinprick sensation in the region that is supplied by the three nerves along with adequate motor block, 30 minutes after injection. The degree of motor block was evaluated 30 minutes after the block procedure. The results of the present study showed that the real time ultrasound guidance of PCB is more effective than ACB approach. Although the sensory blockade of the femoral nerve achieved equally by both techniques, the LFC and OBT nerves were faster and more effectively blocked with PCB technique. Also PCB group showed significant complete sensory block without need for general anesthesia, significant decrease in the post-operative VAS and significant increase time of first analgesic requirement as compared to the ACB group.Result and Conclusion:The present study demonstrates that blockade of lumber plexus by psoas compartment block is more effective in complete sensory block without general anesthesia supplementation in addition to decrease post-operative analgesic requirement than adductor canal block.

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Section: Discussionmentioning

confidence: 99%

Real-time ultrasound-guided comparison of adductor canal block and psoas compartment block combined with sciatic nerve block in laparoscopic knee surgeries

Messeha

2016

Anesth Essays Res

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“…Hence, the knowledge of anatomical localization of the nerve structures of the lumbar plexus would appear to be the prerequisite for performing the "ultrasound-assisted" lumbar plexus block. In 2004, however, the successful identification of the nerve trunks of lumbar plexus in the pediatric cases has been reported (Kirchmair et al, 2004). The successful identification of the lumbar plexs in these pediatric cases had resulted from the superficial localization of the nerve trunks, which allowed the researchers to utilize the higher frequency (5-8MHz) transducer ultrasound equipments.…”

Section: Ultrasound-guided Lumbar Plexus Blockmentioning

confidence: 99%

Aneurysmal Disease of the Thoracic and Abdominal Aorta

Atkins¹,

Bush²

2011

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The first successful open surgical repair of an abdominal aortic aneurysm was in 1951 by Dubost and represented a tremendous milestone in the care of this challenging disease. The introduction of endovascular repair in 1991 by Parodi furthered the care of these patients by allowing for lower morbidity and mortality rates and also, enabling surgeons to extend surgical treatment to patients traditionally deemed too high of a surgical risk. This new book on Aortic Disease covers many interesting and vital topics necessary for both the practicing surgeon as well as a student of vascular disease. The book starts with background information on the evolution of aortic management from traditional open surgical repair to modern endovascular therapies. There is also a chapter covering the data supporting current treatment modalities and how these data have supported modern management. Also, the use of endovascular means for care of the challenging situation of ruptured aneurysms is discussed. In addition to management of abdominal aneurysm, there is a chapter on treatment of aneurysms of the ascending aorta. Along with surgical treatment, one must also understand the molecular basis for how blood vessels remodel and thus, the role of cathepsins in aortic disease is elucidated. Lastly, chapters discussing the perioperative management of radiation exposure and ultrasound-guided nerve blocks as well as the need for high-quality postoperative nutrition will lend well to a full understanding of how to management patients from presentation to hospital discharge. We hope you enjoy this book, its variety of topics, and gain a fuller knowledge of Aneurysmal Disease of the Thoracic and Abdominal Aorta.

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“…The lumbar plexus in paediatric patients was noted to be relatively superficial, requiring less tissue penetration and a high frequency linear probe for better spatial resolution. [ 6 ]…”

mentioning

confidence: 99%