• Lukas Kirchmair, Birgit Enna, Gottfried Mitterschiffthaler, Bernhard Moriggl, Manfred Greher, Peter Marhofer, Stephan Kapral, and Ingmar Gassner.
• Section of Pediatric Radiology, Department of General Pediatrics, University of Innsbruck, Innsbruck, Austria. l.kirchmair@chello.at
• Anesthesiology. 2004 Aug 1;101(2):445-50.

BackgroundPediatric regional anesthesia has gained increasing interest over the past decades. The current study was conducted to investigate the lumbar paravertebral region and the lumbar plexus at L3-L4 and L4-L5 by means of sonography to obtain fundamentals for the performance of ultrasound-guided posterior lumbar plexus blocks.MethodsThirty-two children (12 boys, 20 girls) with American Society of Anesthesiologists physical status I or II were enrolled in the current study. The lumbar paravertebral region was visualized at L3-L4 and L4-L5 on two corresponding posterior sonograms (longitudinal, transverse). The lumbar plexus had to be delineated, and skin-plexus distances were measured. In a series of five pediatric patients undergoing inguinal herniotomy, ultrasound-guided posterior lumbar plexus blocks at L4-L5 were performed.ResultsThe children were stratified into three age groups (group 1: > 3 yr and 5 yr and 8 yr and ConclusionsSonography of the lumbar plexus in children proved to be feasible. Skin-plexus distances correlated with the children's weight rather than with their age. The sonographic findings were fundamental for the performance of successful ultrasound-guided posterior approaches in a small group of pediatric patients.

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