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

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.

Study Overview

• Status: Completed
• Conditions: Volunteers
• Intervention / Treatment: Other: Collection of datas

Detailed Description

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.

• Study Type: Observational
• Enrollment (Actual): 50

Contacts and Locations

Study Locations

• France
  • Saint-Étienne, France
    • CHU Saint-Etienne

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Adult with indication of lumbar echography will be included.

Description

Inclusion Criteria:

• Adult with indication of lumbar echography

Exclusion Criteria:

• Antecedent of spine surgery or spinal malformation

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Adult with lumbar echography indication; Adult with lumbar echography indication will be included.

Other: Collection of datas; 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 The projections of C, >C,

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire de Saint Etienne
• Investigators: Principal Investigator: Maxime WODEY, resident, CHU Saint-Etienne

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2019
• Primary Completion (Actual): April 1, 2019
• Study Completion (Actual): April 1, 2019

Study Registration Dates

• First Submitted: February 27, 2023
• First Submitted That Met QC Criteria: February 27, 2023
• First Posted (Estimate): March 9, 2023

Study Record Updates

• Last Update Posted (Estimate): March 9, 2023
• Last Update Submitted That Met QC Criteria: February 27, 2023
• Last Verified: April 1, 2021

More Information

Terms related to this study

• Keywords: ultrasound guided; Trident; Lumbar plexus; Shamrock
• Other Study ID Numbers: IRBN782021/CHUSTE

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No