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    Introduction Anatomy
Review Indications Contra-
indications Equipment Reference
Points Block Performance Protocols Complications Control Lumbar Plexus Block: Posterior Approach
     by Dr. Philippe Macaire
     Lyon, France Introduction

The traditional approaches to lumbar plexus were previously described by Winnie, Hannah, Dekrey, Parkinson and Chayen. These techniques rely on either eliciting paresthesia in the distribution of the lumbar plexus or on contact with an osseous reference point (processus transversus in particular) to localize the plexus. However, the use of nerve stimulation enables much more precise needle placement and greater success rate. Lumbar plexus block, being a true plexus block (much like the brachial plexus block) has a much higher success rate in achieving anesthesia of the entire lumbar plexus, than the commonly employed block of the nerve ilio-fascial or the 3-in-1 block. Additionally, the relatively recent introduction of equipment for continuous blocks makes it possible not only to administer the block, but also to introduce a catheter for prolong pain management, which has triggered an additional interest in this technique.

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