A case report of an innovative ultrasound-assisted patient tailored lumbar plexus block with alternative anatomical landmarks in a traumatic femur fracture in a 16 year old boy.

Abstract

Lumbar plexus block (LPB) is an advanced regional an-esthesia technique practiced by relatively few experi- enced regional anesthesiologists. Difficulties are linked to the depth of structures and the high risk of accidental punctures, lowering its safety expecially in obese or un- favorable patients. Although modern ultrasound guidance may allow visual- ization of the lumbar plexus, ultrasound-guided techniques (i.e., Shamrock and Trident techniques) still require additional expertise while being operator-depend- ent and not suitable in every patient, which represents the most frequent “real world” scenario. Given its usefulness in lower limbs surgery, we struggled to develop a new ultrasound-assisted patient-tailored Traditional Chinese Medicine based operating protocol to increase its safety and constancy of performance and applied it to a trau- matic right femur fracture surgery of a 16-year-old boy.

Keywords

• pediatric lumbar plexus block; traditional chinese medi- cine; cun; bladder meridian acupuncture