Anterior lumbosacral plexus block outperforms lumbar epidural for lower limb surgery
This randomized trial informs medication safety pharmacists about local anesthetic burden, hemodynamic risk, and rescue analgesia patterns when substituting a single-puncture fascial plane block for lumbar epidural in lower limb orthopedic analgesia.
New block technique outperforms epidurals in lower limb surgery.
Effective pain management in lower limb surgery can improve recovery and patient satisfaction. The novel anterior approach was superior, showing lower pain scores and less rescue medication use compared to epidural (P < 0.001). This method provides effective analgesia with fewer side effects like hypotension and postoperative nausea and vomiting (PONV). Single puncture, dual injection offers better pain control and safety than traditional epidurals for lower limb surgeries.
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Authors:Kaur S, Mohammed S, Chhabra S, Kumar R, Paliwal B, Gahlot N, Bhatia P
Citation:Kaur S, Mohammed S, Chhabra S, et al. Analgesic efficacy of an ultrasound-guided single puncture, dual injection, anterior approach targeting branches of the lumbosacral plexus versus lumbar epidural for unilateral lower limb orthopedic surgery: A randomized controlled study. Journal of anaesthesiology, clinical pharmacology. 2026;42(3):392-399. doi:10.4103/joacp.joacp_394_25
Subscribers receive access to a complete clinical analysis, available online and as a downloadable PDF.
Executive Summary
Study Design
Patient Population
Primary Outcomes
Secondary Outcomes & Safety Profile
Pharmacist Implications
Clinical Pearls
Limitations
Controversies & Evidence Gaps
Cost & Logistics
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