Psoas compartment block

Mannion, Stephen

doi:10.1093/bjaceaccp/mkm029

Cited by 24 publications

(19 citation statements)

References 28 publications

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“…In the operating room, LPB was performed using Chayen’s approach [13, 14]. The puncture site was located 4–5 cm lateral to the posterior midline along the intercristal line.…”

Section: Block Preparationmentioning

confidence: 99%

Combined ultrasound and nerve stimulator-guided deep nerve block may decrease the rate of local anesthetics systemic toxicity: a randomized clinical trial

Zhang

et al. 2019

BMC Anesthesiol

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Background Ultrasound guidance might decrease the incidence of local anesthetics systemic toxicity (LAST) for many peripheral nerve blocks compared with nerve stimulator guidance. However, it remains uncertain whether ultrasound guidance is superior to nerve stimulator guidance for deep nerve block of the lower extremity. This study was designed to investigate whether deep nerve block with ultrasound guidance would decrease the incidence of LAST compared with that with nerve stimulator guidance, and to identify associated risk factors of LAST. Methods Three hundred patients undergoing elective lower limb surgery and desiring lumbar plexus blocks (LPBs) and sciatic nerve blocks (SNBs) were enrolled in this study. The patients were randomly assigned to receive LPBs and SNBs with ultrasound guidance (group U), nerve stimulator guidance (group N) or dual guidance (group M). The primary outcome was the incidence of LAST. The secondary outcomes were the number of needle redirection, motor and sensory block onset and nerve distribution restoration time, as well as associated risk factors. Results There were 18 patients with LAST, including 12 in group U, 4 in group N and 2 in group M. By multiple comparisons among the three groups, we found that the incidence of LAST in group U (12%) was significantly higher than that in group N (4%)( P = 0.037) and group M(2%)( P = 0.006). The OR of LAST with hepatitis B (HBV) infection and the female sex was 3.352 (95% CI,1.233–9.108, P = 0.013) and 9.488 (95% CI,2.142–42.093, P = 0.0004), respectively. Conclusions Ultrasound guidance, HBV infection and the female sex were risk factors of LAST with LPBs and SNBs. For patients infected with HBV or female patients receiving LPBs and SNBs, we recommended that combined ultrasound and nerve stimulator guidance should be used to improve the safety. Trial registration This study was approved by the Ethical Committee of the First Affiliated Hospital of Army Medical University. The protocol was registered prospectively with the Chinese Clinical Trial Registry ( ChiCTR-IOR-16008099 ) on March 15, 2016.

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“…In the operating room, LPB was performed using Chayen’s approach [13, 14]. The puncture site was located 4–5 cm lateral to the posterior midline along the intercristal line.…”

Section: Block Preparationmentioning

confidence: 99%

Combined ultrasound and nerve stimulator-guided deep nerve block may decrease the rate of local anesthetics systemic toxicity: a randomized clinical trial

Zhang

et al. 2019

BMC Anesthesiol

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“…Although the literature reports volumes of local anaesthetic ranging between 28 and 40 ml for successful lumbar plexus block , higher volumes are associated with a greater risk of epidural spread and local anaesthetic toxicity . Moreover, when higher doses of local anaesthetic are required to optimise postoperative analgesia, the risk of quadriceps weakness significantly increases and the time for rehabilitation is prolonged .…”

Section: Discussionmentioning

confidence: 99%

“…Lumbar plexus block is a useful technique for hip and knee surgery . The posterior approach to the lumbar plexus provides anaesthesia of the femoral, obturator and lateral femoral cutaneous nerves, allowing reliable sensory and motor block of the anterior, medial and lateral portions of the hip and knee joints .…”

Section: Introductionmentioning

confidence: 99%

A randomised controlled comparison between stimulating and standard catheters for lumbar plexus block

et al. 2015

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SummaryThe aim of this randomised, prospective, blinded study was to evaluate if stimulating catheters can decrease the minimum effective anaesthetic volume in 50% of patients during lumbar plexus block using mepivacaine 1.5% compared with standard catheters. Fifty-eight patients of ASA physical status 1-3 were randomly allocated to receive a lumbar plexus block via a stimulating or standard catheter, with 29 in each group. The first dose was 30 ml and subsequent doses were determined using the up-and-down staircase method. The minimum effective anaesthetic volume 50 was 12.2 ml (95% CI 7.3-17.1 ml) using the stimulating catheter and 24.8 ml (95% CI 23.2-27.5 ml) with the standard catheter (p < 0.0001). Complete lumbar plexus block was achieved with the initial dose of mepivacaine in 29 (100%) patients in the stimulating catheter group and 20 (69%) patients in the standard catheter group (p = 0.002). This study showed that use of a stimulating catheter halves the minimum effective anaesthetic volume 50 of mepivacaine 1.5% while increasing the success rate in patients receiving continuous lumbar plexus block.

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“…A PCB, with or without a sciatic nerve block, is of great value for postoperative analgesia after hip surgery. Different studies described a reduction of pain scores and a reduced consumption of rescue opioids after hip surgery due to the addition of a PCB [ 17 , 25 , 27 , 28 ]. Stevens et al described significant lower pain scores at T = 6 hours after total hip arthroplasty in patients receiving a single-injection posterior lumbar plexus block combined with general anesthesia, compared with patients who did not receive a PCB (VAS 1.4 ± 1.3 versus 2.4 ± 1.4, P = .007) [ 17 ].…”

Section: Clinical Efficacymentioning

confidence: 99%

“…Türker et al described no significant differences in analgesic potency between a PCB and epidural analgesia for patients undergoing partial hip replacement surgery [ 33 ]. This implies a certain preference for a PCB as a postoperative analgesic strategy for hip surgery, because undesired side effects of epidural analgesia, such as urinary retention, hypotension, and pruritis, are avoided and the possibility of prolonged postoperative analgesia can be maintained [ 28 , 34 ].…”

Section: Clinical Efficacymentioning

confidence: 99%

The Psoas Compartment Block for Hip Surgery: The Past, Present, and Future

Leeuw

Zuurmond

Pérez

2011

Anesthesiology Research and Practice

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A posterior lumbar plexus block or psoas compartment block (PCB) is an effective locoregional anesthetic technique for analgesia and anesthesia of the entire lower extremity including the hip. Since the first description in the early seventies, this technique has been modified based on advanced knowledge of the anatomical localization of the lumbar plexus and the improvement of technical equipment. This paper provides an overview of the history, clinical efficacy, and risk profile of the PCB focused on hip surgery. Current status and future expectations are discussed.

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Psoas compartment block

Cited by 24 publications

References 28 publications

Combined ultrasound and nerve stimulator-guided deep nerve block may decrease the rate of local anesthetics systemic toxicity: a randomized clinical trial

Combined ultrasound and nerve stimulator-guided deep nerve block may decrease the rate of local anesthetics systemic toxicity: a randomized clinical trial

A randomised controlled comparison between stimulating and standard catheters for lumbar plexus block

The Psoas Compartment Block for Hip Surgery: The Past, Present, and Future

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