Lumbar Longissimus Plane (LLP) Block for Lumbar Laminectomy скачать в хорошем качестве

Lumbar Longissimus Plane (LLP) Block for Lumbar Laminectomy

Ultrasound-guided Lumbar Longissimus Plane (LLP) Block ( also was called Modified Thoracolumbar Interfascial Plane (m TLIP) Block) for Postoperative Pain Control on Lumbar Laminectomy Jeff L. Xu, MD Division of Regional Anesthesiology & Acute Pain Management, Department of Anesthesiology Westchester Medical Center/ New York Medical College Valhalla, NY, USA • Patients undergoing lumbar laminectomy have often carried the additional diagnosis of chronic pain and have high baseline opioid requirements, which make postoperative pain management more difficult. • Bilateral Lumbar Longissimus Plane (LLP) Block targets only the dorsal rami of the thoracolumbar nerves, it has been performed for postoperative pain control on lumbar laminectomy. • This video shows ultrasound-guided Lumbar Longissimus Plane (LLP) Block. • After the surgical wound was closed, the patient was kept in prone position under general anesthesia. A 10 cm, 21G, EchoBlock needle was placed at the level of the L4 spinous process, in a lateral to medial orientation traversing to an area between the iliocostalis and longissimus muscles, with curve ultrasound probe. • This video shows ultrasound-guided modified thoracolumbar interfascial plane block (mTLIP). • After the surgical wound was closed, the patient was kept in prone position under general anesthesia. A 10 cm, 21G, EchoBlock needle was placed at the level of the L4 spinous process, in a lateral to medial orientation traversing to an area between the iliocostalis and longissimus muscles, with curve ultrasound probe. • 0.25% bupivacaine 20 ml was injected between the longissimus and iliocostalis muscles. Acknowledgement: Thanks Dr. Tara Doherty for the introduction and Victoria Xu for editing the video and the permission of publishing her digital drawing. References: 1. Jeff L. Xu, Tara Doherty, Ruchik Patel, John Galeno, Bernd Dotzauer.Analgesic efficacy of ultrasound-guided modified thoracolumbar interfascial plane block performed with the use of neurophysiology monitoring for postoperative lumbar surgery. Journal of Clinical Anesthesia. 2019 Feb 52; 21-23 2. Ahiskalioglu A, Yayik AM, Doymus O, Selvitopi K. Efficacy of ultrasound-guided modified thoracolumbar interfascial plane block for postoperative analgesia after spinal surgery: a randomized-controlled trial. Can J Anesth. 2018;65(5):603-604. 3. Jeff L. Xu, Victor Tseng. Proposal to standardize the nomenclature for paraspinal interfascial plane blocks. Reg Anesth Pain Med. 2019 Jun 19; PubMed PMID: 31221745.