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Trajectory avoiding kidney and ureter injury for percutaneous lumbar sympathetic block.

Hwang BY, Kim TK, Han YH, Kwon JY, Kim HK - Korean J Anesthesiol (2014)

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Pusan National University School of Medicine, Busan, Korea.

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These studies tried to find the relationship between the measurements and the characteristics of the patients also... However, its results showed some confusing outcomes... BMI covariates were modeled for cL... The cL, cM, aL and aM of L2 or L3 were best described with gender, age or BMI covariates as follows:cL: 69.9 (60.3 for L2) - 0.444 × (age-54) + 1.73 × (BMI-23.6) + 9.4 (male)cM: 45.1 (38.7 for L2) - 0.142 × (age-54) + 5.5 (male)aL: 28.7 (24.2 for L2) - 0.229 × (age-54) + 3.9 (male)aM: 15.2 (12 for L2) - 0.114 × (age-54) + 1.9 (male) The measurements of male were generally longer or wider than that of females... The Covariate modeling revealed a relation of cL is with gender, age and BMI of the patients. cL became shorter with increasing age... On the contrary, as larger the BMI, as longer was the cL... The negative coefficient of age covariate was assumed to be associated with a reducing muscular mass and subcutaneous fat during the aging process... Such simulation gives us a warning to be very cautious about patients with an extreme age and a lean body. cL showed a great difference if we compared a 30 years old male with BMI 30 and an 80 years female with BMI 18... So, as already mentioned, a very careful consideration should be done if a PLS is performed in a person with high age and lean body mass... Even the number of subjects included in this study was small, the mixed effect modeling has been thought as an effective method to find out the interindividual variabilities... There might be a risk to apply resulted equations to subjects whose covariates are out of bound of this study... In the clinical reality, the outmost lateral point (cL) would be shorter than the value of this study, because the investigated images were filmed in a supine position while the PLS is usually done in a prone position... Conclusively, this study could show quantitative relationships between the safety windows for PLS and covariates such as gender, BMI, age and vertebral levels at the same time.

No MeSH data available.


It shows the schematic picture of measurements method. c: skin point which meets with central sagittal line, t: target point of lumbar plexus block, L: lateral limit skin point, M: medial limit skin point, cM or cL: distance between c and M or L, tM or tL: distance between t and M or L, aL and aM: angle which is made by central sagittal line and tL and tM, respectively.
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Figure 1: It shows the schematic picture of measurements method. c: skin point which meets with central sagittal line, t: target point of lumbar plexus block, L: lateral limit skin point, M: medial limit skin point, cM or cL: distance between c and M or L, tM or tL: distance between t and M or L, aL and aM: angle which is made by central sagittal line and tL and tM, respectively.

Mentions: In spite of the many benefits of percutaneous lumbar sympathectomy (PLS) it also has several complications or side effects such as genitofemoral neuralgia, lumbar plexus damage or damages to organs and blood vessels. Among them, the damages on kidney or ureter are rare but serious complications [1,2]. Avoiding these complications, the needle entry point should not exceed a certain distance to the midline as cL shown in Fig. 1. At the same time, the entry point should also keep some distance to the midline to avoid a damage of the lumbar plexus cM as shown in Fig. 1.


Trajectory avoiding kidney and ureter injury for percutaneous lumbar sympathetic block.

Hwang BY, Kim TK, Han YH, Kwon JY, Kim HK - Korean J Anesthesiol (2014)

It shows the schematic picture of measurements method. c: skin point which meets with central sagittal line, t: target point of lumbar plexus block, L: lateral limit skin point, M: medial limit skin point, cM or cL: distance between c and M or L, tM or tL: distance between t and M or L, aL and aM: angle which is made by central sagittal line and tL and tM, respectively.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4295957&req=5

Figure 1: It shows the schematic picture of measurements method. c: skin point which meets with central sagittal line, t: target point of lumbar plexus block, L: lateral limit skin point, M: medial limit skin point, cM or cL: distance between c and M or L, tM or tL: distance between t and M or L, aL and aM: angle which is made by central sagittal line and tL and tM, respectively.
Mentions: In spite of the many benefits of percutaneous lumbar sympathectomy (PLS) it also has several complications or side effects such as genitofemoral neuralgia, lumbar plexus damage or damages to organs and blood vessels. Among them, the damages on kidney or ureter are rare but serious complications [1,2]. Avoiding these complications, the needle entry point should not exceed a certain distance to the midline as cL shown in Fig. 1. At the same time, the entry point should also keep some distance to the midline to avoid a damage of the lumbar plexus cM as shown in Fig. 1.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology and Pain Medicine, Pusan National University School of Medicine, Busan, Korea.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

These studies tried to find the relationship between the measurements and the characteristics of the patients also... However, its results showed some confusing outcomes... BMI covariates were modeled for cL... The cL, cM, aL and aM of L2 or L3 were best described with gender, age or BMI covariates as follows:cL: 69.9 (60.3 for L2) - 0.444 × (age-54) + 1.73 × (BMI-23.6) + 9.4 (male)cM: 45.1 (38.7 for L2) - 0.142 × (age-54) + 5.5 (male)aL: 28.7 (24.2 for L2) - 0.229 × (age-54) + 3.9 (male)aM: 15.2 (12 for L2) - 0.114 × (age-54) + 1.9 (male) The measurements of male were generally longer or wider than that of females... The Covariate modeling revealed a relation of cL is with gender, age and BMI of the patients. cL became shorter with increasing age... On the contrary, as larger the BMI, as longer was the cL... The negative coefficient of age covariate was assumed to be associated with a reducing muscular mass and subcutaneous fat during the aging process... Such simulation gives us a warning to be very cautious about patients with an extreme age and a lean body. cL showed a great difference if we compared a 30 years old male with BMI 30 and an 80 years female with BMI 18... So, as already mentioned, a very careful consideration should be done if a PLS is performed in a person with high age and lean body mass... Even the number of subjects included in this study was small, the mixed effect modeling has been thought as an effective method to find out the interindividual variabilities... There might be a risk to apply resulted equations to subjects whose covariates are out of bound of this study... In the clinical reality, the outmost lateral point (cL) would be shorter than the value of this study, because the investigated images were filmed in a supine position while the PLS is usually done in a prone position... Conclusively, this study could show quantitative relationships between the safety windows for PLS and covariates such as gender, BMI, age and vertebral levels at the same time.

No MeSH data available.