Psoas compartment block in children: Part I - description of the technique

• Published in: Pediatric anesthesia 2005-06, Vol.15 (6), p.461-464
• Main Authors: SCHUEPFER, GUIDO, JÖHR, MARTIN
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesia, Epidural; Anesthesia, Inhalation; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Child; children: regional anesthesia; Electric Stimulation; Humans; Linear Models; Lower Extremity - surgery; Medical sciences; Nerve Block; Orthopedic Procedures; psoas compartment block; Treatment Failure
• ISSN: 1155-5645; 1460-9592
• DOI: 10.1111/j.1460-9592.2005.01467.x

Summary Background : Until recently only small series of psoas compartment blocks (PCB) in children have been reported. A high incidence of epidural spread as an important side effect was noted. A series of 100 consecutive blocks using new standardized landmarks is reported. Methods : In 100 consecutive children (5.9–106 kg) PCB was performed using a nerve stimulator. In the lateral position, the needle was inserted between the medial 2/3 and the lateral 1/3 on a line from the spinous process of L4 to the posterior superior iliac spine. The blocks were performed by residents in training under supervision of one specific designated pediatric anesthetist. Results : All blocks were clinically successful. In 64% only one attempt was necessary, in 26 patients two attempts were necessary and in 10 patients more than two attempts were necessary. In 16% a vascular puncture occurred. In one patient with a dense unilateral block a partial epidural spread occurred. No serious complications were observed during the perioperative period. Conclusions : The described new technique has a very high success rate with no relevant side effects. Although only one case of epidural spread occurred, PCB remains an invasive technique with the potential for serious complications.