Circumpsoas block – an anterior myofascial plane block for lumbar plexus elements: case report
In an attempt to improvise the analgesia in patients with femoral fractures, we aimed at depositing local anesthetic deep to anterior psoas fascia (APf) under ultrasound (US) guidance to block lumbar plexus elements which emerge lateral, anterior, and medial to the psoas major muscle. We termed this as circumpsoas block (CPB). Clinical and computed tomography contrast studies revealed that a continuous CPB infusion with a catheter provided a reliable block of the lumbar plexus elements. No adverse were events noted. We conclude that US guided CPB is a reliable technique for managing postoperative pain after surgery of femur fractures.
1 X. Capdevila, P. Biboulet, M. Bouregba, et al. Comparison of the three-in-one and fascia iliaca compartment blocks in adults: clinical and radiographic analysis Anesth Analg, 86 (1998), pp. 1039-1044
2 M. Desmet, A.L. Balocco, V. Van Belleghem Fascia iliaca compartment blocks: Different techniques and review of the literature Best Pract Res Clin Anaesthesiol, 33 (2019), pp. 57-66
3 M. Desmet, K. Vermeylen, I. Van Herreweghe, et al. A Longitudinal Supra-Inguinal Fascia Iliaca Compartment Block Reduces Morphine Consumption After Total Hip Arthroplasty Reg Anesth Pain Med, 42 (2017), pp. 327-333
4 K. Vermeylen, M. Desmet, I. Leunen, et al. Supra-inguinal injection for fascia iliaca compartment block results in more consistent spread towards the lumbar plexus than an infra-inguinal injection: a volunteer study Reg Anesth Pain Med (2019), 10.1136/rapm-2018-100092 Ahead of print
5 L. Kirchmair, P. Lirk, J. Colvin, et al. Lumbar plexus and psoas major muscle: not always as expected Reg Anesth Pain Med, 33 (2008), pp. 109-114