A Novel Approach to Ultrasound-guided Out-of-plane Lumbar Plexus Block Using the Shamrock Technique: Technical Report

Lumbar plexus blockade can be performed using both the classical landmark technique and ultrasound guidance. Reports suggest that ultrasound-guided blockade may enhance the safety of the procedure. Various approaches can be utilized for ultrasound-guided lumbar plexus blockade, including the paravertebral paramedian transverse scan, the Shamrock approach, and Trident imaging. In these imaging methods, needle guidance can be accomplished using either an in-plane or out-of-plane technique. Each of these application methods has limitations concerning needle imaging and guidance. In this case report, we present the outcomes of five patients who underwent lumbar plexus blockade for hip fracture surgery using an out-of-plane approach with Shamrock imaging, which could serve as a viable alternative to other methods.