Ultrasound Guided Lumbar Plexus Block
Mohammed Abd El-Samiee Mohammed;
Abstract
Summary
T
he Lumbar Plexus describes the association of nerves derived from the segmental lumbar spinal roots. The lumbar plexus receives input from L1 (variable input from T12) to L4 and produces the femoral nerve, lateral cutaneous nerve of the thigh, obturator nerve, as well as the iliohypogastric, ilioinguinal and genitofemoral nerves.
This block is mainly indicated for the management of pain following unilateral lower limb surgery principally of the knee, femur or hip. It is less useful as a sole anaesthetic technique because there is no blockade of the sciatic nerve, which has major innervation of the posterior thigh, the lower leg and usually has some innervation of both the hip and knee joint. Thus complete anaesthesia or analgesia of the whole lower limb requires the addition of a sciatic nerve block Alternatives for providing regional anaesthesia or analgesia of the lower limb are central neuroaxial blockade: Epidural or Sub-Arachnoid (spinal) technique.
These techniques generally produce bilateral effects such as reduced mobility, which may be undesirable or unnecessary, and are frequently associated with the risk of urinary retention. They also have their own risks and complications, especially the feared epidural haematoma or abscess.
T
he Lumbar Plexus describes the association of nerves derived from the segmental lumbar spinal roots. The lumbar plexus receives input from L1 (variable input from T12) to L4 and produces the femoral nerve, lateral cutaneous nerve of the thigh, obturator nerve, as well as the iliohypogastric, ilioinguinal and genitofemoral nerves.
This block is mainly indicated for the management of pain following unilateral lower limb surgery principally of the knee, femur or hip. It is less useful as a sole anaesthetic technique because there is no blockade of the sciatic nerve, which has major innervation of the posterior thigh, the lower leg and usually has some innervation of both the hip and knee joint. Thus complete anaesthesia or analgesia of the whole lower limb requires the addition of a sciatic nerve block Alternatives for providing regional anaesthesia or analgesia of the lower limb are central neuroaxial blockade: Epidural or Sub-Arachnoid (spinal) technique.
These techniques generally produce bilateral effects such as reduced mobility, which may be undesirable or unnecessary, and are frequently associated with the risk of urinary retention. They also have their own risks and complications, especially the feared epidural haematoma or abscess.
Other data
| Title | Ultrasound Guided Lumbar Plexus Block | Other Titles | التخدير الموضعي للضفيرة القطنية العصبية الموجه بالموجات فوق الصوتية | Authors | Mohammed Abd El-Samiee Mohammed | Issue Date | 2014 |
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