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Updated: Jun 23, 2026
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Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
Published on: January 31, 2025
Ultrasound localization of the sacral plexus using a parasacral approach
Alon Y Ben-Ari1, Rama Joshi, Anna Uskova
1Department of Anesthesiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Anesthesia and Analgesia
|May 19, 2009
Summary
This study demonstrates the feasibility of using ultrasound guidance for locating the sacral plexus nerve via a parasacral approach. This technique successfully identified the sacral plexus in patients, paving the way for improved regional anesthesia.
Area of Science:
- Anesthesiology
- Radiology
- Neuroscience
Background:
- The sacral plexus is crucial for lower limb innervation.
- Accurate localization is essential for regional anesthesia and pain management.
- Current localization methods may have limitations.
Purpose of the Study:
- To assess the feasibility of ultrasound-guided sacral plexus localization.
- To evaluate a parasacral approach for sacral plexus identification.
- To determine the accuracy and safety of this technique.
Main Methods:
- Ultrasound (2-5 MHz curved probe) was used to scan the parasacral region in 17 patients.
- Key anatomical landmarks (ischial bone, sacrum) were identified.
- Nerve stimulation confirmed sacral plexus localization.
Main Results:
- The sacral plexus was successfully identified as a hyperechoic structure in the sciatic foramen.
- Gluteal arteries were visualized in 10/17 patients.
- Motor responses confirmed sacral plexus localization with low current (0.2-0.5 mA).
Conclusions:
- Ultrasound-guided parasacral approach is feasible for sacral plexus localization.
- This technique offers a reliable method for identifying the sacral plexus.
- No complications were reported, suggesting a safe procedure.
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