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Lumbar plexus in children. A sonographic study and its relevance to pediatric regional anesthesia

Lukas Kirchmair1, Birgit Enna, Gottfried Mitterschiffthaler

  • 1Section of Pediatric Radiology, Department of General Pediatrics, University of Innsbruck, Innsbruck, Austria. l.kirchmair@chello.at

Anesthesiology
|July 28, 2004
PubMed

Insights

Ultrasound imaging of the lumbar plexus in children is feasible for performing ultrasound-guided posterior lumbar plexus blocks. Skin-plexus distances correlate with weight, aiding in pediatric regional anesthesia.

Area of Science:

  • Pediatric Anesthesiology
  • Regional Anesthesia
  • Medical Imaging

Background:

  • Pediatric regional anesthesia is increasingly utilized.
  • Ultrasound-guided techniques offer advantages in pediatric anesthesia.
  • Understanding lumbar plexus anatomy is crucial for effective blocks.

Purpose of the Study:

  • To investigate the lumbar paravertebral region and lumbar plexus using sonography at L3-L4 and L4-L5 in children.
  • To establish fundamental data for performing ultrasound-guided posterior lumbar plexus blocks.
  • To correlate sonographic measurements with patient demographics.

Main Methods:

  • Sonographic visualization of the lumbar paravertebral region and lumbar plexus at L3-L4 and L4-L5 in 32 children (ASA I-II).
  • Measurement of skin-plexus distances.
  • Performance of ultrasound-guided posterior lumbar plexus blocks in 5 pediatric patients undergoing inguinal herniotomy.

Main Results:

  • The lumbar plexus was successfully delineated in a high percentage of cases across different age groups.
  • The lumbar plexus was consistently located within the posterior psoas major muscle.
  • Skin-plexus distances showed significant differences between age groups and correlated positively with patient weight.

Conclusions:

  • Sonography of the lumbar plexus in children is feasible and provides essential anatomical information.
  • Skin-plexus distances are more closely related to children's weight than age.
  • Ultrasound-guided posterior approaches to the lumbar plexus are effective for pediatric anesthesia and analgesia.
Abstract

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