الفهرس | Only 14 pages are availabe for public view |
Abstract This study investigated the role of the injection pressures during lumbar plexus block on bilateral or neuroaxial spread of local anesthetic. Sixty patients scheduled for knee arthroscopy, divided randomly into 3 groups 20 patients each according to injection pressure to low injection pressure (< 15 psi), intermediate injection pressure (15-20 psi) and high injection pressure (> 20 psi), under standard nerve stimulator–guided lumbar plexus block using 35 ml bupivacaine, 0.5%. The injection pressure was assessed by an inline injection pressure monitor (BSmart®; Concert Medical LLC, Norwell, MA). The block success rate and the presence of bilateral sensory and/or motor blockade were being evaluated. In this study injection of local anesthetic under low injection pressure (<15psi), the block was effective, without neuroaxial spread or controlateral spread, while under intermediate injection pressures (15-20) there was incidence of controlateral spread (15%) without neuroaxial spread, however with high injection pressure (> 20 psi) the results was associated with high incidence of unwanted bilateral blockade (50%) and neuroaxial spread with a dermatomal sensory level at T11or higher |