A description of the spread of injectate after psoas compartment block using magnetic resonance imaging.

Hdl Handle:
http://hdl.handle.net/10147/208877
Title:
A description of the spread of injectate after psoas compartment block using magnetic resonance imaging.
Authors:
Mannion, Stephen; Barrett, Jack; Kelly, Denis; Murphy, Damian B; Shorten, George D
Affiliation:
Department of Anaesthesia and Intensive Care, Cork University Hospital &, University College, Cork, Ireland. mannionstephen@hotmail.com
Citation:
Reg Anesth Pain Med. 2005 Nov-Dec;30(6):567-71.
Journal:
Regional anesthesia and pain medicine
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/208877
DOI:
10.1016/j.rapm.2005.08.004
PubMed ID:
16326342
Abstract:
BACKGROUND AND OBJECTIVES: Magnetic resonance imaging (MRI) provides for excellent visualization of spread of solution after peripheral nerve block. The aim of this observational study was to utilize MRI to describe the distribution of injectate (gadopentetate dimeglumine) administered for continuous psoas compartment block (PCB) performed by use of two approaches (Capdevila and modified Winnie) and to describe the spread of injectate to the lumbar plexus. METHODS: Four volunteers were enrolled in a prospective crossover study. Each volunteer underwent PCB with catheter placement performed by use of Capdevila's approach followed 1 week later by PCB, with catheter placement performed by use of a modified Winnie approach. MRI of injectate distribution was performed after each PCB. RESULTS: The catheter was unable to be inserted in 1 volunteer undergoing Winnie's approach; therefore, 7 sets of MR images were analyzed. In 6 of 7 cases (4 Capdevila and 2 Winnie) spread was primarily within the psoas muscle. Contrast surrounded the L2-3 lumbar branch of the femoral nerve at L4 and cleaved the fascial plane within the psoas muscle and spread cephalad to reach the lumbar nerve roots. In 1 case (Winnie approach) contrast spread between the psoas and quadratus lumborum muscles. Contrast surrounded the femoral and obturator nerves where they lie outside the psoas muscle at L5. CONCLUSION: The most common pattern of injectate spread seen on MRI with both approaches to PCB was spread within the body of the psoas muscle around the lumbar branches (L2-4), with cephalad spread to the lumbar nerve roots. One catheter resulted in injectate between the psoas and quadratus lumborum muscles.
Language:
eng
MeSH:
Adult; Contrast Media/*administration & dosage; Cross-Over Studies; Gadolinium DTPA/*administration & dosage; Humans; Lumbosacral Plexus/*pathology; *Magnetic Resonance Imaging; Male; Nerve Block/*methods; Prospective Studies; Psoas Muscles/innervation/pathology
ISSN:
1098-7339 (Print); 1098-7339 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMannion, Stephenen_GB
dc.contributor.authorBarrett, Jacken_GB
dc.contributor.authorKelly, Denisen_GB
dc.contributor.authorMurphy, Damian Ben_GB
dc.contributor.authorShorten, George Den_GB
dc.date.accessioned2012-02-03T15:06:13Z-
dc.date.available2012-02-03T15:06:13Z-
dc.date.issued2012-02-03T15:06:13Z-
dc.identifier.citationReg Anesth Pain Med. 2005 Nov-Dec;30(6):567-71.en_GB
dc.identifier.issn1098-7339 (Print)en_GB
dc.identifier.issn1098-7339 (Linking)en_GB
dc.identifier.pmid16326342en_GB
dc.identifier.doi10.1016/j.rapm.2005.08.004en_GB
dc.identifier.urihttp://hdl.handle.net/10147/208877-
dc.description.abstractBACKGROUND AND OBJECTIVES: Magnetic resonance imaging (MRI) provides for excellent visualization of spread of solution after peripheral nerve block. The aim of this observational study was to utilize MRI to describe the distribution of injectate (gadopentetate dimeglumine) administered for continuous psoas compartment block (PCB) performed by use of two approaches (Capdevila and modified Winnie) and to describe the spread of injectate to the lumbar plexus. METHODS: Four volunteers were enrolled in a prospective crossover study. Each volunteer underwent PCB with catheter placement performed by use of Capdevila's approach followed 1 week later by PCB, with catheter placement performed by use of a modified Winnie approach. MRI of injectate distribution was performed after each PCB. RESULTS: The catheter was unable to be inserted in 1 volunteer undergoing Winnie's approach; therefore, 7 sets of MR images were analyzed. In 6 of 7 cases (4 Capdevila and 2 Winnie) spread was primarily within the psoas muscle. Contrast surrounded the L2-3 lumbar branch of the femoral nerve at L4 and cleaved the fascial plane within the psoas muscle and spread cephalad to reach the lumbar nerve roots. In 1 case (Winnie approach) contrast spread between the psoas and quadratus lumborum muscles. Contrast surrounded the femoral and obturator nerves where they lie outside the psoas muscle at L5. CONCLUSION: The most common pattern of injectate spread seen on MRI with both approaches to PCB was spread within the body of the psoas muscle around the lumbar branches (L2-4), with cephalad spread to the lumbar nerve roots. One catheter resulted in injectate between the psoas and quadratus lumborum muscles.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshContrast Media/*administration & dosageen_GB
dc.subject.meshCross-Over Studiesen_GB
dc.subject.meshGadolinium DTPA/*administration & dosageen_GB
dc.subject.meshHumansen_GB
dc.subject.meshLumbosacral Plexus/*pathologyen_GB
dc.subject.mesh*Magnetic Resonance Imagingen_GB
dc.subject.meshMaleen_GB
dc.subject.meshNerve Block/*methodsen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshPsoas Muscles/innervation/pathologyen_GB
dc.titleA description of the spread of injectate after psoas compartment block using magnetic resonance imaging.en_GB
dc.contributor.departmentDepartment of Anaesthesia and Intensive Care, Cork University Hospital &, University College, Cork, Ireland. mannionstephen@hotmail.comen_GB
dc.identifier.journalRegional anesthesia and pain medicineen_GB
dc.description.provinceMunster-

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