Lumbar plexus anesthesia: Psoas compartment block

Abstract

The lumbar plexus is formed from the ventral rami of L1-L4 with variable contributions from T12 and L5. The plexus forms within the substance of the psoas major muscle and the peripheral branches and continues to the lower extremity between the psoas and the quadratus lumborum muscles. The block at this level includes all the peripheral branches of the lumbar plexus. The technique includes the use of a peripheral nerve stimulator. When combined with a sciatic nerve block, it provides excellent surgical anesthesia to the entire lower extremity and is an alternative for lower limb anesthesia when a central neuroaxial blockade is contraindicated. Psoas compartment block provides excellent anesthesia and analgesia for the regions supplied by the lumbar plexus. A continuous catheter technique increases the duration of the block and postoperative analgesia.