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ORIGINAL ARTICLE
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Intricacies of ultrasound-guided lumbar plexus block in octogenarians: A retrospective case series


1 Department of Anaesthesiology, Sancheti Hospital, Pune, Maharashtra, India
2 Department of Anaesthesiology, Ibra Hospital, Ministry of Health, Ibra, Sultanate of Oman
3 Department of Orthopedics, Sancheti Hospital, Pune, Maharashtra, India

Correspondence Address:
Abhijit Nair,
Department of Anaesthesiology, Ibra Hospital, Ministry of Health, Ibra
Sultanate of Oman
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Source of Support: None, Conflict of Interest: None

Background: Ultrasound (US)-guided lumbar plexus block (LPB) could be technically challenging in elderly patients. The lumbar paravertebral sonoanatomy is undescribed in the elderly. In an attempt to understand the relevant sonoanatomy, identify the lumbar plexus elements, and understand the difficulties that encountered while performing LPB in elderly patients, we retrospectively analyzed US of 23 elderly patients who were administered US-guided LPBs. Methods: After institutional ethics committee approval, we retrospectively reviewed stored US images of lumbar paravertebral sonoanatomy in 23 elderly patients and analyzed psoas major muscle, lumbar vertebral body, lumbar nerve, and lumbar artery. Results: On US examination, features of psoas major muscle, lumbar vertebral body, lumbar nerve, and lumbar artery were noted and analyzed. Conclusion: US-guided visualization of the components of the lumbar paravertebral area is difficult and inconsistent in the elderly. Therefore, we suggest performing a scout scan, identify the structures, and use neurostimulation all the time for performing LPB in these patients.


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    -  Diwan S
    -  Nair A
    -  Dadke M
    -  Sancheti P
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