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REGIONAL ANESTHESIA

In with the New, Out with the Old? Comparison of Two Approaches for Psoas Compartment Block

Department of Anaesthesia and Intensive Care, Cork University Hospital; St. Mary's Orthopaedic Hospital; and University College, Cork, Ireland

Address correspondence to Stephen Mannion, MRCPI, FCARCSI, Department of Anesthesia and Intensive Care, Cork University Hospital, Cork, Ireland. Address e-mail to mannionstephen{at}hotmail.com. No reprints will be available.

We compared the approaches of Winnie and Capdevila for psoas compartment block (PCB) performed by a single operator in terms of contralateral spread, lumbar plexus blockade, and postoperative analgesic efficacy. Sixty patients underwent PCB (0.4 mL/kg levobupivacaine 0.5%) and subsequent spinal anesthesia for primary joint arthroplasty (hip or knee) in a prospective, double-blind study. Patients were randomly allocated to undergo PCB by using the Capdevila (group C; n = 30) or a modified Winnie (group W; n = 30) approach. Contralateral spread and lumbar plexus blockade were assessed 15, 30, and 45 min after PCB. Contralateral spread (bilateral from T4 to S5) and femoral and lateral cutaneous nerve block were evaluated by sensory testing, and obturator motor block was assessed. Bilateral anesthesia occurred in 10 patients in group C and 12 patients in group W (P = 0.8). Blockade of the femoral, lateral cutaneous, and obturator nerves was 90%, 93%, and 80%, respectively, for group C and 93%, 97%, and 90%, respectively, for group W (P > 0.05). No differences were found in PCB procedure time, pain scores, 24-h morphine consumption, or time to first morphine analgesia.

This article has been cited by other articles:

				Q. H. De Tran, A. Clemente, and R. J. Finlayson A review of approaches and techniques for lower extremity nerve blocks: [Un bilan des approches et techniques pour les blocs nerveux du membre inferieur] Can J Anesth, November 1, 2007; 54(11): 922 - 934. [Abstract] [Full Text] [PDF]

				S. Mannion Psoas compartment block CEACCP, October 1, 2007; 7(5): 162 - 166. [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999