Lumbar plexus in children. A sonographic study and its relevance to pediatric regional anesthesia
Pediatric regional anesthesia has gained increasing interest over the past decades. The current study was conducted to investigate the lumbar paravertebral region and the lumbar plexus at L3-L4 and L4-L5 by means of sonography to obtain fundamentals for the performance of ultrasound-guided posterior...
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| Veröffentlicht in: | Anesthesiology (Philadelphia) 2004-08, Vol.101 (2), p.445-450 |
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| creator | Kirchmair, Lukas Enna, Birgit Mitterschiffthaler, Gottfried Moriggl, Bernhard Greher, Manfred Marhofer, Peter Kapral, Stephan Gassner, Ingmar |
| description | Pediatric regional anesthesia has gained increasing interest over the past decades. The current study was conducted to investigate the lumbar paravertebral region and the lumbar plexus at L3-L4 and L4-L5 by means of sonography to obtain fundamentals for the performance of ultrasound-guided posterior lumbar plexus blocks.
Thirty-two children (12 boys, 20 girls) with American Society of Anesthesiologists physical status I or II were enrolled in the current study. The lumbar paravertebral region was visualized at L3-L4 and L4-L5 on two corresponding posterior sonograms (longitudinal, transverse). The lumbar plexus had to be delineated, and skin-plexus distances were measured. In a series of five pediatric patients undergoing inguinal herniotomy, ultrasound-guided posterior lumbar plexus blocks at L4-L5 were performed.
The children were stratified into three age groups (group 1: > 3 yr and 5 yr and 8 yr and |
| doi_str_mv | 10.1097/00000542-200408000-00026 |
| format | Article |
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Thirty-two children (12 boys, 20 girls) with American Society of Anesthesiologists physical status I or II were enrolled in the current study. The lumbar paravertebral region was visualized at L3-L4 and L4-L5 on two corresponding posterior sonograms (longitudinal, transverse). The lumbar plexus had to be delineated, and skin-plexus distances were measured. In a series of five pediatric patients undergoing inguinal herniotomy, ultrasound-guided posterior lumbar plexus blocks at L4-L5 were performed.
The children were stratified into three age groups (group 1: > 3 yr and </= 5 yr; group 2: > 5 yr and </= 8 yr; group 3: > 8 yr and </= 12 yr). The lumbar plexus could be delineated at L3-L4 and L4-L5 in 19 of 20 cases in group 1, in 17 of 20 cases in group 2, in 22 of 24 cases at L3-L4 in group 3, and in 16 of 24 cases at L4-L5 in group 3. In all patients, the lumbar plexus was situated within the posterior part of the psoas major muscle. Skin-plexus distances showed statistical significant differences between groups 1 and 3 and between groups 2 and 3. The strongest positive correlation existed between skin-plexus distances and the children's weight. Ultrasound guidance enabled safe und successful posterior approaches to the lumbar plexus, thus resulting in effective anesthesia and analgesia of the inguinal region.
Sonography of the lumbar plexus in children proved to be feasible. Skin-plexus distances correlated with the children's weight rather than with their age. The sonographic findings were fundamental for the performance of successful ultrasound-guided posterior approaches in a small group of pediatric patients.</description><identifier>ISSN: 0003-3022</identifier><identifier>DOI: 10.1097/00000542-200408000-00026</identifier><identifier>PMID: 15277928</identifier><language>eng</language><publisher>United States</publisher><subject>Aging - physiology ; Anesthesia, Spinal ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Hernia, Inguinal - surgery ; Humans ; Lumbosacral Plexus - diagnostic imaging ; Male ; Needles ; Skin - diagnostic imaging ; Ultrasonography</subject><ispartof>Anesthesiology (Philadelphia), 2004-08, Vol.101 (2), p.445-450</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15277928$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kirchmair, Lukas</creatorcontrib><creatorcontrib>Enna, Birgit</creatorcontrib><creatorcontrib>Mitterschiffthaler, Gottfried</creatorcontrib><creatorcontrib>Moriggl, Bernhard</creatorcontrib><creatorcontrib>Greher, Manfred</creatorcontrib><creatorcontrib>Marhofer, Peter</creatorcontrib><creatorcontrib>Kapral, Stephan</creatorcontrib><creatorcontrib>Gassner, Ingmar</creatorcontrib><title>Lumbar plexus in children. A sonographic study and its relevance to pediatric regional anesthesia</title><title>Anesthesiology (Philadelphia)</title><addtitle>Anesthesiology</addtitle><description>Pediatric regional anesthesia has gained increasing interest over the past decades. The current study was conducted to investigate the lumbar paravertebral region and the lumbar plexus at L3-L4 and L4-L5 by means of sonography to obtain fundamentals for the performance of ultrasound-guided posterior lumbar plexus blocks.
Thirty-two children (12 boys, 20 girls) with American Society of Anesthesiologists physical status I or II were enrolled in the current study. The lumbar paravertebral region was visualized at L3-L4 and L4-L5 on two corresponding posterior sonograms (longitudinal, transverse). The lumbar plexus had to be delineated, and skin-plexus distances were measured. In a series of five pediatric patients undergoing inguinal herniotomy, ultrasound-guided posterior lumbar plexus blocks at L4-L5 were performed.
The children were stratified into three age groups (group 1: > 3 yr and </= 5 yr; group 2: > 5 yr and </= 8 yr; group 3: > 8 yr and </= 12 yr). The lumbar plexus could be delineated at L3-L4 and L4-L5 in 19 of 20 cases in group 1, in 17 of 20 cases in group 2, in 22 of 24 cases at L3-L4 in group 3, and in 16 of 24 cases at L4-L5 in group 3. In all patients, the lumbar plexus was situated within the posterior part of the psoas major muscle. Skin-plexus distances showed statistical significant differences between groups 1 and 3 and between groups 2 and 3. The strongest positive correlation existed between skin-plexus distances and the children's weight. Ultrasound guidance enabled safe und successful posterior approaches to the lumbar plexus, thus resulting in effective anesthesia and analgesia of the inguinal region.
Sonography of the lumbar plexus in children proved to be feasible. Skin-plexus distances correlated with the children's weight rather than with their age. The sonographic findings were fundamental for the performance of successful ultrasound-guided posterior approaches in a small group of pediatric patients.</description><subject>Aging - physiology</subject><subject>Anesthesia, Spinal</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cross-Sectional Studies</subject><subject>Female</subject><subject>Hernia, Inguinal - surgery</subject><subject>Humans</subject><subject>Lumbosacral Plexus - diagnostic imaging</subject><subject>Male</subject><subject>Needles</subject><subject>Skin - diagnostic imaging</subject><subject>Ultrasonography</subject><issn>0003-3022</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1kMtOwzAQRb0A0VL4BeQVu5SxHdvJsqqAIlViA-vIcSatkfPAThD9e4woI43uXOloXoRQBmsGpX6A35A5zzhADkUyWUquLsgyqcgEcL4g1zF-JKulKK7IgkmudcmLJTH7uatNoKPH7zlS11N7dL4J2K_phsahHw7BjEdnaZzm5kRN31A3RRrQ45fpLdJpoCM2zkwhQQEPbuiNTxzG6YjRmRty2Rof8fasK_L-9Pi23WX71-eX7WafjRz0lHFVgJWWKZ5DbRjPZaOFLWpRqtaKmqFpC6iFtSAlqKJFIdLVSqcSBEIpVuT-r-8Yhs85Ta86Fy16n1YZ5lgppXPIBUvg3Rmc6w6bagyuM-FU_T9F_ACmSWNe</recordid><startdate>200408</startdate><enddate>200408</enddate><creator>Kirchmair, Lukas</creator><creator>Enna, Birgit</creator><creator>Mitterschiffthaler, Gottfried</creator><creator>Moriggl, Bernhard</creator><creator>Greher, Manfred</creator><creator>Marhofer, Peter</creator><creator>Kapral, Stephan</creator><creator>Gassner, Ingmar</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>200408</creationdate><title>Lumbar plexus in children. A sonographic study and its relevance to pediatric regional anesthesia</title><author>Kirchmair, Lukas ; Enna, Birgit ; Mitterschiffthaler, Gottfried ; Moriggl, Bernhard ; Greher, Manfred ; Marhofer, Peter ; Kapral, Stephan ; Gassner, Ingmar</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p207t-2680c5c16240ba1245d73c8b396fc3b1eaf80b3cc055068fe330546768f03e093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Aging - physiology</topic><topic>Anesthesia, Spinal</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cross-Sectional Studies</topic><topic>Female</topic><topic>Hernia, Inguinal - surgery</topic><topic>Humans</topic><topic>Lumbosacral Plexus - diagnostic imaging</topic><topic>Male</topic><topic>Needles</topic><topic>Skin - diagnostic imaging</topic><topic>Ultrasonography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kirchmair, Lukas</creatorcontrib><creatorcontrib>Enna, Birgit</creatorcontrib><creatorcontrib>Mitterschiffthaler, Gottfried</creatorcontrib><creatorcontrib>Moriggl, Bernhard</creatorcontrib><creatorcontrib>Greher, Manfred</creatorcontrib><creatorcontrib>Marhofer, Peter</creatorcontrib><creatorcontrib>Kapral, Stephan</creatorcontrib><creatorcontrib>Gassner, Ingmar</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Anesthesiology (Philadelphia)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kirchmair, Lukas</au><au>Enna, Birgit</au><au>Mitterschiffthaler, Gottfried</au><au>Moriggl, Bernhard</au><au>Greher, Manfred</au><au>Marhofer, Peter</au><au>Kapral, Stephan</au><au>Gassner, Ingmar</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lumbar plexus in children. A sonographic study and its relevance to pediatric regional anesthesia</atitle><jtitle>Anesthesiology (Philadelphia)</jtitle><addtitle>Anesthesiology</addtitle><date>2004-08</date><risdate>2004</risdate><volume>101</volume><issue>2</issue><spage>445</spage><epage>450</epage><pages>445-450</pages><issn>0003-3022</issn><abstract>Pediatric regional anesthesia has gained increasing interest over the past decades. The current study was conducted to investigate the lumbar paravertebral region and the lumbar plexus at L3-L4 and L4-L5 by means of sonography to obtain fundamentals for the performance of ultrasound-guided posterior lumbar plexus blocks.
Thirty-two children (12 boys, 20 girls) with American Society of Anesthesiologists physical status I or II were enrolled in the current study. The lumbar paravertebral region was visualized at L3-L4 and L4-L5 on two corresponding posterior sonograms (longitudinal, transverse). The lumbar plexus had to be delineated, and skin-plexus distances were measured. In a series of five pediatric patients undergoing inguinal herniotomy, ultrasound-guided posterior lumbar plexus blocks at L4-L5 were performed.
The children were stratified into three age groups (group 1: > 3 yr and </= 5 yr; group 2: > 5 yr and </= 8 yr; group 3: > 8 yr and </= 12 yr). The lumbar plexus could be delineated at L3-L4 and L4-L5 in 19 of 20 cases in group 1, in 17 of 20 cases in group 2, in 22 of 24 cases at L3-L4 in group 3, and in 16 of 24 cases at L4-L5 in group 3. In all patients, the lumbar plexus was situated within the posterior part of the psoas major muscle. Skin-plexus distances showed statistical significant differences between groups 1 and 3 and between groups 2 and 3. The strongest positive correlation existed between skin-plexus distances and the children's weight. Ultrasound guidance enabled safe und successful posterior approaches to the lumbar plexus, thus resulting in effective anesthesia and analgesia of the inguinal region.
Sonography of the lumbar plexus in children proved to be feasible. Skin-plexus distances correlated with the children's weight rather than with their age. The sonographic findings were fundamental for the performance of successful ultrasound-guided posterior approaches in a small group of pediatric patients.</abstract><cop>United States</cop><pmid>15277928</pmid><doi>10.1097/00000542-200408000-00026</doi><tpages>6</tpages></addata></record> |
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| subjects | Aging - physiology Anesthesia, Spinal Child Child, Preschool Cross-Sectional Studies Female Hernia, Inguinal - surgery Humans Lumbosacral Plexus - diagnostic imaging Male Needles Skin - diagnostic imaging Ultrasonography |
| title | Lumbar plexus in children. A sonographic study and its relevance to pediatric regional anesthesia |
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