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Lumbar plexus block: an anatomical study

M H Hanna1, S J Peat, F D'Costa

  • 1Department of Anaesthesia, King's College Hospital, London.

Anaesthesia
|August 1, 1993
PubMed
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A new posterior approach for lumbar plexus blockade was tested in cadavers. Dye spread was limited to the psoas muscle, confirming a safe and simple technique for lumbar plexus anesthesia.

Area of Science:

  • Anesthesiology
  • Anatomy
  • Regional Anesthesia

Background:

  • Lumbar plexus blockade is a key regional anesthesia technique.
  • Various approaches exist, each with potential risks and benefits.
  • A simple and safe posterior approach is desirable.

Purpose of the Study:

  • To describe and evaluate a novel posterior approach for lumbar plexus blockade.
  • To assess the spread of injectate using a cadaveric model.
  • To determine the safety and efficacy of this technique.

Main Methods:

  • A single-needle posterior approach at the L2-3 interspace was used in six cadavers.
  • Dye injection was followed by photographic documentation and dissection.
  • Patient studies with CT/X-ray confirmed cadaveric findings.

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Main Results:

  • In all cadavers, dye remained within the posterior psoas muscle.
  • Dye spread along the lumbar plexus nerves.
  • No spread was observed anterior to the psoas, to the sacral plexus, or into the epidural/subarachnoid spaces.

Conclusions:

  • This posterior approach provides a simple and safe method for lumbar plexus blockade.
  • The technique confines injectate spread, minimizing risks to adjacent structures.
  • It does not require imaging guidance for needle placement.