Document Detail

Incidence of genitofemoral nerve block during lumbar sympathetic block: comparison of two lumbar injection sites.
MedLine Citation:
PMID:  9425975     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVES: Genitofemoral nerve (GFN) block is a known side effect of a lumbar sympathetic block (LSB), although the incidence has not been well documented. Furthermore, genitofemoral neuralgia can occur following neurolytic LSB. Because the level at which the GFN exits the psoas sheath varies, this study was designed to identify differences in the incidence of GFN block following LSB at the level of the second versus the fourth lumbar vertebrae. METHODS: Patients requiring LSB to evaluate chronic lower extremity pain were prospectively studied. Patients were injected at the second lumbar (L2 group) or fourth lumbar (L4 group) vertebral body depending on the location of the pain syndrome in the lower extremity. Lumbar sympathetic blocks were performed using 10 mL of a 0.5% bupivacaine solution with radiocontrast; spread of injectate was verified using fluoroscopy. An observer evaluating for presence of GFN block was blinded to the lumbar level of injection. RESULTS: Thirty patients were enrolled (L2 group, n = 15; L4 group, n = 15). Spread of local anesthetic/radiocontrast solution was limited to approximately one vertebral body above and one below the target level. There was no difference in the ability to achieve a LSB; success rates were 66% and 73% using L2 and L4, respectively. The incidence of GFN block was 0% (0/15) in the L2 group versus 40% (6/15) in the L4 group; this was statistically significant (P = .017, Fisher's exact test). CONCLUSIONS: The GFN is less likely to be blocked when the LSB is performed near the second lumbar vertebra as compared with the fourth lumbar vertebra.
S C Sayson; S Ramamurthy; J Hoffman
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Regional anesthesia     Volume:  22     ISSN:  0146-521X     ISO Abbreviation:  Reg Anesth     Publication Date:    1997 Nov-Dec
Date Detail:
Created Date:  1998-02-10     Completed Date:  1998-02-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7707549     Medline TA:  Reg Anesth     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  569-74     Citation Subset:  IM    
Department of Surgery, Brooke Army Medical Center, Fort Sam Houston, San Antonio, Texas 78234-6200, USA.
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MeSH Terms
Anesthesia, Spinal / adverse effects*,  methods
Autonomic Nerve Block / adverse effects*,  methods
Chronic Disease
Double-Blind Method
Femoral Nerve / drug effects
Middle Aged
Neuralgia / chemically induced
Pain / therapy
Peripheral Nervous System Diseases / chemically induced*
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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