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Journal of the Korean Academy of Rehabilitation Medicine 2000;24(2):249-258.
Anatomical Review and Clinical Effect of Psoas Compartment Block.
Shin, Kyoung Ho , Choi, Rak Min , Kim, Heon , Kim, Hee Sang , Ahn, Kyung Hoi
1Department of Rehabilitation Medicine, Korea Veterans Hospital.
2Department of Anesthesiology, Korea Veterans Hospital.
3Department of Rehabilitation Medicine, Kyung Hee University College of Medicine.
대요근 근구 차단술의 해부학적 고찰 및 임상 효과
신경호, 최락민1, 김헌, 김희상2, 안경회2
한국보훈병원 재활의학과, 1마취과 및 2경희대학교 의과대학 재활의학교실
Abstract

Objective
The purposes of this study were to evaluate the relation of the lumbar plexus with the psoas compartment, to measure the distance from skin to psoas compartment, and to determine the efficacy of psoas compartment block for the unilateral leg pain and/or low back pain.


Method
Six cadavers were dissected and the computed tomography of the lumbar region were performed in 22 subjects. The psoas compartment block of 10 ml of 0.5 percent lidocaine were performed in 31 patients with unilateral leg pain and/or low back pain. Visual Analog Scale (VAS) and sensory, motor functions were assessed before the block and 5, 30 minutes, and 1, 2, 3 hours and 1 week after the block. The distance from skin to psoas compartment were measured during the procedure. The questionnaires on the procedure were completed after 1 week.


Results
Cadaver dissections demonstrated that the 3 main nerves of lumbar plexus were within the psoas compartment between the level of L4 and L5. Computed tomography provided that the average distances of anterior and posterior borders of psoas major from the low back skin were 10.8 & 6.3 cm and that of medial & lateral borders from the median sagital plane were 2.9 & 7.1 cm respectively. There were statistically significant correlations between distance from skin to psoas compartment and body weight, abdominal circumference as well as body mass index (p<0.0001). The VAS was 7.7 before the block and 5.4 1 week after the block (p<0.05) and satisfactory outcomes were shown in 71 percent of the subjects.


Conclusion
Psoas compartment block was effective for the patients with unilateral leg pain and/or low back pain without major side effects and complications.

Key Words: Psoas compartment, Lumbar plexus nerves, Psoas compartment block
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