الفهرس 
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Abstract
This study investigated the role of the injection pressures during lumbar
plexus block on bilateral or neuroaxial spread of local anesthetic. Sixty patients
scheduled for knee arthroscopy, divided randomly into 3 groups 20 patients each
according to injection pressure to low injection pressure (< 15 psi), intermediate
injection pressure (15-20 psi) and high injection pressure (> 20 psi), under standard
nerve stimulator–guided lumbar plexus block using 35 ml bupivacaine, 0.5%. The
injection pressure was assessed by an inline injection pressure monitor (BSmart®;
Concert Medical LLC, Norwell, MA). The block success rate and the presence of
bilateral sensory and/or motor blockade were being evaluated.
In this study injection of local anesthetic under low injection pressure
(<15psi), the block was effective, without neuroaxial spread or controlateral
spread, while under intermediate injection pressures (15-20) there was incidence of
controlateral spread (15%) without neuroaxial spread, however with high injection
pressure (> 20 psi) the results was associated with high incidence of unwanted
bilateral blockade (50%) and neuroaxial spread with a dermatomal sensory level at
T11or higher