Which Approach to Favor for Ultrasound-guided Lumbar Plexus Block (BPLE). Comparative Study.
Study Details
Study Description
Brief Summary
Lumbar plexus block is described as a difficult block, thus requiring experienced practitioners. Many techniques have been used to date, notably anatomical landmarks, neurostimulation, and ultrasound-guided techniques. Among ultrasound-guided techniques, the "Trident" technique was described in 2006, while the "Shamrock" technique was described in 2013. Trident consists in putting the probe sagittally next to the lumbar spine and injecting local anesthetic around the lumbar plexus inside the psoas muscle at the level of L4. It is an out-of-plane puncture.
Shamrock puts the probe transversely on the iliac crest. Authors of the 2013 article said the image obtained with this technique was an image of L4. This technique allows an in-plane puncture, which is a safe technique.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
This study aims at describing the level obtained with Shamrock, as well as at comparing depth of lumbar plexus, image quality and presence of vessels between the two techniques.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Adult with lumbar echography indication Adult with lumbar echography indication will be included. |
Other: Collection of datas
Analysis lumbar echographies results by Trident ans Shamrock techniques.
Costiform processes on T12 to L5 were spotted and noted. For Trident technique, quality of image, depth of lumbar plexus and presence of vessels were noted.
Shamrock technique was performed, the projection of C line (line obtained with a probe put on the iliac crest) was noted with the invisible ink pen. Then the probe was oriented cephalically (for line >C) and caudally (line <C). For each lines, quality of image, depth of lumbar plexus and presence of vessels were also noted.
The projections of C, >C, <C on the costiform processes were noted.
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Outcome Measures
Primary Outcome Measures
- Projection of line C on the costiform processes [Day: 0]
Analysis by trident techniques results.
Secondary Outcome Measures
- Depth of lumbar plexus [Day: 0]
Analysis by trident and shamrock techniques results.
- image quality [Day: 0]
Analysis by trident and shamrock techniques results.
- presence of vessels [Day: 0]
Analysis by trident and shamrock techniques results.
Eligibility Criteria
Criteria
Inclusion Criteria:
- Adult with indication of lumbar echography
Exclusion Criteria:
- Antecedent of spine surgery or spinal malformation
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | CHU Saint-Etienne | Saint-Étienne | France |
Sponsors and Collaborators
- Centre Hospitalier Universitaire de Saint Etienne
Investigators
- Principal Investigator: Maxime WODEY, resident, CHU Saint-Etienne
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- IRBN782021/CHUSTE