Which Approach to Favor for Ultrasound-guided Lumbar Plexus Block (BPLE). Comparative Study.

Study Overview
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Brief Summary
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Lumbar plexus block is described as a difficult block, thus requiring experienced practitioners. Many techniques have been used to date, notably anatomical landmarks, neurostimulation, and ultrasound-guided techniques. Among ultrasound-guided techniques, the Trident technique was described in 2006, while the Shamrock technique was described in 2013. Trident consists in putting the probe sagittally next to the lumbar spine and injecting local anesthetic around the lumbar plexus inside the psoas muscle at the level of L4. It is an out-of-plane puncture. Shamrock puts the probe transversely on the iliac crest. Authors of the 2013 article said the image obtained with this technique was an image of L4. This technique allows an in-plane puncture, which is a safe technique.

Detailed Description
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This study aims at describing the level obtained with Shamrock, as well as at comparing depth of lumbar plexus, image quality and presence of vessels between the two techniques.

Official Title
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Which Approach to Favor for Ultrasound-guided Lumbar Plexus Block (BPLE). Comparative Study.

Conditions
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Volunteers

Intervention / Treatment
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* Other: Collection of datas


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult with indication of lumbar echography Exclusion Criteria: Antecedent of spine surgery or spinal malformation

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Adult with lumbar echography indication<br>Adult with lumbar echography indication will be included. | Other: Collection of datas<br>* Analysis lumbar echographies results by Trident ans Shamrock techniques. Costiform processes on T12 to L5 were spotted and noted. For Trident technique, quality of image, depth of lumbar plexus and presence of vessels were noted. Shamrock technique was performed, the projection of C line (line obtained with a probe put on the iliac crest) was noted with the invisible ink pen. Then the probe was oriented cephalically (for line >C) and caudally (line <C). For each lines, quality of image, depth of lumbar plexus and presence of vessels were also noted. The projections of C, >C, <C on the costiform processes were noted.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Projection of line C on the costiform processes | Analysis by trident techniques results. | Day: 0 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Depth of lumbar plexus | Analysis by trident and shamrock techniques results. | Day: 0 | 
| image quality | Analysis by trident and shamrock techniques results. | Day: 0 | 
| presence of vessels | Analysis by trident and shamrock techniques results. | Day: 0 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Trident, Lumbar plexus, ultrasound guided, Shamrock