An anatomical study of the parasacral block using magnetic resonance imaging of healthy volunteers.

Hdl Handle:
http://hdl.handle.net/10147/206295
Title:
An anatomical study of the parasacral block using magnetic resonance imaging of healthy volunteers.
Authors:
O'Connor, Maeve; Coleman, Margaret; Wallis, Fintan; Harmon, Dominic
Affiliation:
Department of Anesthesia and Intensive Care Medicine, Mid-Western Regional, Hospital, Dooradoyle, Limerick, Ireland.
Citation:
Anesth Analg. 2009 May;108(5):1708-12.
Journal:
Anesthesia and analgesia
Issue Date:
31-Jan-2012
URI:
http://hdl.handle.net/10147/206295
DOI:
10.1213/ane.0b013e31819b065e
PubMed ID:
19372359
Abstract:
BACKGROUND: The parasacral approach to sciatic blockade is reported to be easy to learn and perform, with a high success rate and few complications. METHODS: Using magnetic resonance imaging, we evaluated the accuracy of a simulated needle (perpendicular to skin) in contacting the sacral plexus with this approach in 10 volunteers. Intrapelvic structures encountered during the simulated parasacral blocks were also recorded. RESULTS: The sacral plexus was contacted by the simulated needle in 4 of the 10 volunteers, and the sciatic nerve itself in one volunteer. The plexus was accurately located adjacent to a variety of visceral structures, including small bowel, blood vessels, and ovary. In the remaining five volunteers (in whom the plexus was not contacted on first needle pass), small bowel, rectum, blood vessels, seminal vesicles, and bony structures were encountered. Historically, when plexus is not encountered, readjustment of the needle insertion point more caudally has been recommended. We found that such an adjustment resulted in simulated perforation of intrapelvic organs or the perianal fossa. CONCLUSIONS: These findings question the reliability of the anatomical landmarks of the parasacral block and raise the possibility of frequent visceral puncture using this technique.
Language:
eng
MeSH:
Adult; Computer Simulation; Female; Humans; Injections; Lumbosacral Plexus/*anatomy & histology; *Magnetic Resonance Imaging, Interventional; Male; Nerve Block/adverse effects/*methods; Reference Values; Sciatic Nerve/*anatomy & histology; Wounds, Penetrating/etiology/prevention & control
ISSN:
1526-7598 (Electronic); 0003-2999 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorO'Connor, Maeveen_GB
dc.contributor.authorColeman, Margareten_GB
dc.contributor.authorWallis, Fintanen_GB
dc.contributor.authorHarmon, Dominicen_GB
dc.date.accessioned2012-01-31T16:46:40Z-
dc.date.available2012-01-31T16:46:40Z-
dc.date.issued2012-01-31T16:46:40Z-
dc.identifier.citationAnesth Analg. 2009 May;108(5):1708-12.en_GB
dc.identifier.issn1526-7598 (Electronic)en_GB
dc.identifier.issn0003-2999 (Linking)en_GB
dc.identifier.pmid19372359en_GB
dc.identifier.doi10.1213/ane.0b013e31819b065een_GB
dc.identifier.urihttp://hdl.handle.net/10147/206295-
dc.description.abstractBACKGROUND: The parasacral approach to sciatic blockade is reported to be easy to learn and perform, with a high success rate and few complications. METHODS: Using magnetic resonance imaging, we evaluated the accuracy of a simulated needle (perpendicular to skin) in contacting the sacral plexus with this approach in 10 volunteers. Intrapelvic structures encountered during the simulated parasacral blocks were also recorded. RESULTS: The sacral plexus was contacted by the simulated needle in 4 of the 10 volunteers, and the sciatic nerve itself in one volunteer. The plexus was accurately located adjacent to a variety of visceral structures, including small bowel, blood vessels, and ovary. In the remaining five volunteers (in whom the plexus was not contacted on first needle pass), small bowel, rectum, blood vessels, seminal vesicles, and bony structures were encountered. Historically, when plexus is not encountered, readjustment of the needle insertion point more caudally has been recommended. We found that such an adjustment resulted in simulated perforation of intrapelvic organs or the perianal fossa. CONCLUSIONS: These findings question the reliability of the anatomical landmarks of the parasacral block and raise the possibility of frequent visceral puncture using this technique.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshComputer Simulationen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshInjectionsen_GB
dc.subject.meshLumbosacral Plexus/*anatomy & histologyen_GB
dc.subject.mesh*Magnetic Resonance Imaging, Interventionalen_GB
dc.subject.meshMaleen_GB
dc.subject.meshNerve Block/adverse effects/*methodsen_GB
dc.subject.meshReference Valuesen_GB
dc.subject.meshSciatic Nerve/*anatomy & histologyen_GB
dc.subject.meshWounds, Penetrating/etiology/prevention & controlen_GB
dc.titleAn anatomical study of the parasacral block using magnetic resonance imaging of healthy volunteers.en_GB
dc.contributor.departmentDepartment of Anesthesia and Intensive Care Medicine, Mid-Western Regional, Hospital, Dooradoyle, Limerick, Ireland.en_GB
dc.identifier.journalAnesthesia and analgesiaen_GB
dc.description.provinceMunster-

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