Efficacy of "over iliac crest method" for ultrasound-guided posterior lumbar plexus block: a comparison with manual palpation and sagittal positioning
10.3760/cma.j.issn.0254-1416.2018.06.016
- VernacularTitle:髂嵴消失定位法用于超声引导后路腰丛神经阻滞的效果:与人工触诊法和旁矢状位法比较
- Author:
Kun CHEN
1
;
Ji LI
;
Xijian KE
;
Xi WU
;
Wenjun LI
;
Wei MEI
;
Yuke TIAN
Author Information
1. 430030,华中科技大学同济医学院附属同济医院麻醉科
- Keywords:
Lumbosacral plexus;
Nerve block;
Ilium
- From:
Chinese Journal of Anesthesiology
2018;38(6):699-702
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the efficacy of "over iliac crest method" for ultrasound-guided posterior lumbar plexus block by comparing with manual palpation and sagittal positioning.Methods A total of 75 patients,aged 25-64 yr,weighing 42-90 kg,with body mass index of 17-32 kg/cm2,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,scheduled for elective lower extremity surgery under ultrasound-guided posterior lumbar plexus block combined with parasacral sciatic nerve block,were divided into 3 groups (n =25 each) using a random number table method:manual palpation group (group M),sagittal positioning group (group S) and "over iliac crest method" group (group O).Patients received ultrasound-guided posterior lumbar plexus block with in-plane technique using the corresponding positioning method in M,S and O groups.Successful blockade of each level was recorded at 30 min after injection.Time to determine the lumbar intervertebral space,puncture time for lumbar plexus block,the requirement for adjuvant drugs and block efficacy were recorded.The development of complications related to puncture and nerve block was also recorded.Results Compared with group M,the success rates of blockade at levels L1 and L2 were significantly increased,the success rates of blockade at levels L4 and L5 were decreased (P＜0.05),no significant difference was found in the success rate of blockade at level L3 (P＞0.05),the time to determine the lumbar intervertebral space was prolonged,and the requirement for adjuvant drugs was decreased during surgery in O and S groups,and the efficacy of block was significantly enhanced in group O (P＜0.05).Compared with group S,the success rates of blockade at levels L1 and L2 were significantly increased,the success rates of blockade at level L4 were decreased,the time to determine the lumbar intervertebral space was shortened (P＜0.05),and no significant change was found in the efficacy of block in group O (P＞0.05).There was no significant difference in the puncture time for lumbar plexus block between the three groups (P＞0.05).Complications related to puncture and nerve block were not found in three groups.Conclusion "Over iliac crest method" provides higher success rate and better efficacy than manual palpation and sagittal positioning when used for lumbar plexus block.
