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Results for “LUMBOSACRAL PLEXUS”

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At least 505 records · Page 28Linked to original sources
PubMed1995

Autonomic nerves cross the posterior plane of rectal dissection.

This investigation was an anatomical study to determine whether branches of the pre-sacral autonomic plexus cross the posterior plane of surgical dissection to supply the rectum. Initially four cadaver hemi-pelves were dissected. Twelve patients undergoing full rectal mobilization were then studied at operation. In all subjects the pre-sacral nerves were arranged as a plexus below the sacral promontory, rather than as individual left and right nerve trunks. Structures thought to be nerves were identified crossing the plane of posterior mobilization of the rectum. They were traced towards their origin and destination, photographed and representative fibres biopsied. A total of 42 such structures were biopsied (16 in cadavers, 26 in operative cases) and 40 were confirmed to be nerves. These nerves connect the pre-sacral autonomic plexus with the posterior aspect of the rectum and were found at all sacral levels. In the operative cases the level of the positive biopsies were S1-six, S2-six, S3-five, S4-four, S5-three. The posterior plane of rectal dissection is therefore crossed by autonomic nerves that innervate the rectum. The pre-sacral nerves have been found to form a plexus in all subjects.

Adult↗
PubMed1993

MR imaging of the sacral plexus: normal findings.

Imaging of the sacral plexus requires evaluation of both intradural and extradural components with cross-sectional techniques. Although CT is useful, individual extradural sacral nerves and the sacral plexus usually cannot be distinguished from adjacent structures. The higher contrast resolution provided by MR imaging allows the region of the sacral plexus to be examined in greater detail. With MR imaging, the constant relationship of the neural components to one another, and the gluteal vessels in their course from the sacrum to the greater sciatic foramen, can be shown consistently. An understanding of the anatomy of this area in multiple planes can aid in more accurate localization of abnormalities involving the sacral plexus. This pictorial essay reviews the MR appearance of the region of the sacral plexus.

Cadaver↗
PubMed2004

Delayed retroperitoneal haematoma after failed lumbar plexus block.

A 72-yr-old patient was to undergo a left lumbar plexus block by the posterior approach to achieve postoperative analgesia after hip replacement. The block failed after three unsuccessful attempts to identify nerve structures and a fascia iliaca compartment block was performed. Postoperatively the patient received enoxaparin and then phenylindanedione for thromboprophylaxis. She was re-admitted 2 weeks after surgery because of a lower limb motor deficit and a left retroperitoneal haematoma requiring blood transfusion. Clinicians need to be aware of this potential complication of lumbar plexus block in patients receiving thrombphylaxis.

Aged↗
PubMedDate not supplied

An observational study of combined continuous lumbar plexus and single-shot sciatic nerve blocks for post-knee surgery analgesia.

BACKGROUND AND OBJECTIVES: In a study of postoperative analgesia after major knee surgery, an assessment was made of the efficacy of continuous lumbar plexus block combined with a single-shot block of the sciatic nerve. METHODS: Continuous perivascular femoral and parasacral sciatic nerve blocks were performed in 59 patients of both sexes, who had undergone either total knee replacement or cruciate ligament reconstruction. An independent assessment of postoperative pain control and side effects was made. RESULTS: The combination technique produced pain control of good quality, combined with a low incidence of excessive sedation and emesis. Nausea and vomiting were infrequent, and no excess sedation, untoward side effects, or complications were noted. CONCLUSIONS: Sciatic nerve block is essential for successful analgesia during the immediate postoperative period but is not mandatory for longer-term pain control, which can be achieved by continuous lumbar plexus block.

Adolescent↗