title: A cadaveric study of injectate spread in the psoas compartment with a direct iliopsoas injection suggested for use during surgery.
abstract: Total hip replacement produces significant postoperative pain. Psoas compartment block is the most effective block of the lumbar plexus in terms of pain relief and reduced blood loss. It is a proven regional technique for analgesia and anaesthesia during and after total hip replacement conferring a number of benefits to the patient. However, traditional techniques used to produce this block require increased theatre time and are associated with a number of serious complications. We present a surgeon-delivered technique for producing a lumbar plexus block using direct injection into the iliopsoas muscle when it is visible intraoperatively. This study shows a cadaveric model using methylene blue and radiopaque contrast produces injectate spread in a fashion which would produce a successful lumbar plexus block. This novel technique for lumbar plexus block affords the benefits of psoas compartment block with reduced complications and reduced administration time.
authors.affiliation: Department of Trauma and Orthopaedics, Midwestern Regional and Croom Orthopaedic Hospital, Limerick, Ireland. connorjgreen@gmail.com
authors.forename: Connor
authors.initials: C
authors.lastname: Green
authors.forename: Olivia
authors.initials: O
authors.lastname: Flannery
authors.forename: Jim
authors.initials: J
authors.lastname: Crotty
authors.forename: Patrick
authors.initials: P
authors.lastname: Felle
authors.forename: Dominic
authors.initials: D
authors.lastname: Harmon
authors.forename: Eric
authors.initials: E
authors.lastname: Masterson
mesh_terms: D000779:Anesthetics, Local / Q000493:pharmacokinetics; D019644:Arthroplasty, Replacement, Hip; D006801:Humans; D008160:Lumbosacral Plexus; D008751:Methylene Blue / Q000493:pharmacokinetics; D009407:Nerve Block / Q000379:methods*
chemical_list: D000779:Anesthetics, Local; D008751:Methylene Blue