Incidence of epidural spread after Chayen’s approach to lumbar plexus block: a retrospective study
Autor(a) principal: | |
---|---|
Data de Publicação: | 2020 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista Brasileira de Anestesiologia (Online) |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942020000300202 |
Resumo: | Abstract Background and objectives: The lumbar plexus block (LPB) is a key technique for lower limb surgery. All approaches to the LPB involve a number of complications. We hypothesized that Chayen's approach, which involves a more caudal and more lateral needle entry point than the major techniques described in the literature, would be associated with a lower rate of epidural spread. Method: We reviewed the electronic medical records and chart of all adult patients who underwent orthopedic surgery for Total Hip Arthroplasty (THA) and hip hemiarthroplasty due to osteoarthritis and femoral neck fracture with LPB and Sciatic Nerve Block (SNB) between January 1, 2002, and December 31, 2017, in our institute. The LPB was performed according to Chayen’s technique using a mixture of mepivacaine and levobupivacaine (total volume, 25 mL) and a SNB by the parasacral approach. The sensory and motor block was evaluated bilaterally during intraoperative and postoperative period. Results: A total number of 700 patients with American Society of Anesthesiologists (ASA) physical status I to IV who underwent LPB met the inclusion criteria. The LPB and SNB was successfully performed in all patients. Epidural spread was reported in a single patient (0.14%;p < 0.05), accounting for an 8.30% reduction compared with the other approaches described in the literature. No other complications were recorded. Conclusions: This retrospective study indicates that more caudal and more lateral approach to the LPB, such as the Chayen’s approach, is characterized by a lower epidural spread than the other approach to the LPB. |
id |
SBA-1_2360c5492adb49b5bb168b21254ee587 |
---|---|
oai_identifier_str |
oai:scielo:S0034-70942020000300202 |
network_acronym_str |
SBA-1 |
network_name_str |
Revista Brasileira de Anestesiologia (Online) |
repository_id_str |
|
spelling |
Incidence of epidural spread after Chayen’s approach to lumbar plexus block: a retrospective studyLumbar plexus blockPsoas compartment blockHip surgeryAbstract Background and objectives: The lumbar plexus block (LPB) is a key technique for lower limb surgery. All approaches to the LPB involve a number of complications. We hypothesized that Chayen's approach, which involves a more caudal and more lateral needle entry point than the major techniques described in the literature, would be associated with a lower rate of epidural spread. Method: We reviewed the electronic medical records and chart of all adult patients who underwent orthopedic surgery for Total Hip Arthroplasty (THA) and hip hemiarthroplasty due to osteoarthritis and femoral neck fracture with LPB and Sciatic Nerve Block (SNB) between January 1, 2002, and December 31, 2017, in our institute. The LPB was performed according to Chayen’s technique using a mixture of mepivacaine and levobupivacaine (total volume, 25 mL) and a SNB by the parasacral approach. The sensory and motor block was evaluated bilaterally during intraoperative and postoperative period. Results: A total number of 700 patients with American Society of Anesthesiologists (ASA) physical status I to IV who underwent LPB met the inclusion criteria. The LPB and SNB was successfully performed in all patients. Epidural spread was reported in a single patient (0.14%;p < 0.05), accounting for an 8.30% reduction compared with the other approaches described in the literature. No other complications were recorded. Conclusions: This retrospective study indicates that more caudal and more lateral approach to the LPB, such as the Chayen’s approach, is characterized by a lower epidural spread than the other approach to the LPB.Sociedade Brasileira de Anestesiologia2020-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942020000300202Revista Brasileira de Anestesiologia v.70 n.3 2020reponame:Revista Brasileira de Anestesiologia (Online)instname:Sociedade Brasileira de Anestesiologia (SBA)instacron:SBA10.1016/j.bjane.2020.04.016info:eu-repo/semantics/openAccessRosanò,ElisabettaTavoletti,DiegoLuccarelli,GiuliaCerutti,ElisabettaPecora,Lucaeng2020-09-09T00:00:00Zoai:scielo:S0034-70942020000300202Revistahttps://www.sbahq.org/revista/https://old.scielo.br/oai/scielo-oai.php||sba2000@openlink.com.br1806-907X0034-7094opendoar:2020-09-09T00:00Revista Brasileira de Anestesiologia (Online) - Sociedade Brasileira de Anestesiologia (SBA)false |
dc.title.none.fl_str_mv |
Incidence of epidural spread after Chayen’s approach to lumbar plexus block: a retrospective study |
title |
Incidence of epidural spread after Chayen’s approach to lumbar plexus block: a retrospective study |
spellingShingle |
Incidence of epidural spread after Chayen’s approach to lumbar plexus block: a retrospective study Rosanò,Elisabetta Lumbar plexus block Psoas compartment block Hip surgery |
title_short |
Incidence of epidural spread after Chayen’s approach to lumbar plexus block: a retrospective study |
title_full |
Incidence of epidural spread after Chayen’s approach to lumbar plexus block: a retrospective study |
title_fullStr |
Incidence of epidural spread after Chayen’s approach to lumbar plexus block: a retrospective study |
title_full_unstemmed |
Incidence of epidural spread after Chayen’s approach to lumbar plexus block: a retrospective study |
title_sort |
Incidence of epidural spread after Chayen’s approach to lumbar plexus block: a retrospective study |
author |
Rosanò,Elisabetta |
author_facet |
Rosanò,Elisabetta Tavoletti,Diego Luccarelli,Giulia Cerutti,Elisabetta Pecora,Luca |
author_role |
author |
author2 |
Tavoletti,Diego Luccarelli,Giulia Cerutti,Elisabetta Pecora,Luca |
author2_role |
author author author author |
dc.contributor.author.fl_str_mv |
Rosanò,Elisabetta Tavoletti,Diego Luccarelli,Giulia Cerutti,Elisabetta Pecora,Luca |
dc.subject.por.fl_str_mv |
Lumbar plexus block Psoas compartment block Hip surgery |
topic |
Lumbar plexus block Psoas compartment block Hip surgery |
description |
Abstract Background and objectives: The lumbar plexus block (LPB) is a key technique for lower limb surgery. All approaches to the LPB involve a number of complications. We hypothesized that Chayen's approach, which involves a more caudal and more lateral needle entry point than the major techniques described in the literature, would be associated with a lower rate of epidural spread. Method: We reviewed the electronic medical records and chart of all adult patients who underwent orthopedic surgery for Total Hip Arthroplasty (THA) and hip hemiarthroplasty due to osteoarthritis and femoral neck fracture with LPB and Sciatic Nerve Block (SNB) between January 1, 2002, and December 31, 2017, in our institute. The LPB was performed according to Chayen’s technique using a mixture of mepivacaine and levobupivacaine (total volume, 25 mL) and a SNB by the parasacral approach. The sensory and motor block was evaluated bilaterally during intraoperative and postoperative period. Results: A total number of 700 patients with American Society of Anesthesiologists (ASA) physical status I to IV who underwent LPB met the inclusion criteria. The LPB and SNB was successfully performed in all patients. Epidural spread was reported in a single patient (0.14%;p < 0.05), accounting for an 8.30% reduction compared with the other approaches described in the literature. No other complications were recorded. Conclusions: This retrospective study indicates that more caudal and more lateral approach to the LPB, such as the Chayen’s approach, is characterized by a lower epidural spread than the other approach to the LPB. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-06-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942020000300202 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0034-70942020000300202 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1016/j.bjane.2020.04.016 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Anestesiologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Anestesiologia |
dc.source.none.fl_str_mv |
Revista Brasileira de Anestesiologia v.70 n.3 2020 reponame:Revista Brasileira de Anestesiologia (Online) instname:Sociedade Brasileira de Anestesiologia (SBA) instacron:SBA |
instname_str |
Sociedade Brasileira de Anestesiologia (SBA) |
instacron_str |
SBA |
institution |
SBA |
reponame_str |
Revista Brasileira de Anestesiologia (Online) |
collection |
Revista Brasileira de Anestesiologia (Online) |
repository.name.fl_str_mv |
Revista Brasileira de Anestesiologia (Online) - Sociedade Brasileira de Anestesiologia (SBA) |
repository.mail.fl_str_mv |
||sba2000@openlink.com.br |
_version_ |
1752126630598279168 |