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Updated: Sep 25, 2025

Author Spotlight: Enhancing Success of Ultrasound-Guided Neuraxial Anesthesia in Cases with Difficult Anatomy
Published on: January 31, 2025
Intricacies of Ultrasound-guided Lumbar Plexus Block in Octogenarians: A Retrospective Case Series
Sandeep Diwan1, Abhijit Nair2, Madhuri Dadke1
1Department of Anaesthesiology, Sancheti Hospital, Pune, Maharashtra, India.
Background:
Ultrasound (US)-guided lumbar plexus block (LPB) could be technically challenging in elderly patients. The lumbar paravertebral sonoanatomy is undescribed in the elderly. In an attempt to understand the relevant sonoanatomy, identify the lumbar plexus elements, and understand the difficulties that encountered while performing LPB in elderly patients, we retrospectively analyzed US of 23 elderly patients who were administered US-guided LPBs.
Methods:
After institutional ethics committee approval, we retrospectively reviewed stored US images of lumbar paravertebral sonoanatomy in 23 elderly patients and analyzed psoas major muscle, lumbar vertebral body, lumbar nerve, and lumbar artery.
Results:
On US examination, features of psoas major muscle, lumbar vertebral body, lumbar nerve, and lumbar artery were noted and analyzed.
Conclusion:
US-guided visualization of the components of the lumbar paravertebral area is difficult and inconsistent in the elderly. Therefore, we suggest performing a scout scan, identify the structures, and use neurostimulation all the time for performing LPB in these patients.
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