Lumbar plexus block for the management of acute pain

Traditional methods of managing acute pain have expanded to include PCA and epidural analgesia. The lumbar plexus block can be added to these methods. It is useful for patients undergoing some knee surgeries, both preoperatively and postoperatively. The lumbar plexus innervates both motor and sensory components of much of the anterior and medial aspects of the lower extremities. Used alone or in conjunction with NSAIDs or narcotics, lumbar plexus block avoids the lethargy and altered mental status often associated with effective doses of narcotics. Bupivacaine (Marcaine) is often the anesthetic of choice. This article describes the effective block area, catheter placement, medication administration, and specific nursing care considerations. Evaluation for medication side effects and potential toxicity are included. Potential for future use is explored.