Susceptibility of the genitofemoral and lateral femoral cutaneous nerves to complications from lumbar sympathetic blocks: is there a morphological reason?†

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Susceptibility of the genitofemoral and lateral femoral cutaneous nerves to complications from lumbar sympathetic blocks: is there a morphological reason?† G.C. Feigl, M. Dreu, H. Ulz, C. Breschan, C. Maier, R. Likar British Journal of Anaesthesia Volume 112, Issue 6, Pages 1098-1104 (June 2014) DOI: 10.1093/bja/aet552 Copyright © 2014 The Author(s) Terms and Conditions

Fig 1 Anatomy of the GFN and LFCN from the existing literature compared with the current investigation. In addition, the topography of the LST according to existing literature is shown. British Journal of Anaesthesia 2014 112, 1098-1104DOI: (10.1093/bja/aet552) Copyright © 2014 The Author(s) Terms and Conditions

Fig 2 (a and b) The most frequently documented course of the GFN, with the GFN passing the medial margin of the PM to reach the intervertebral foramen L2/3. The asterisk marks the GFN course according to the literature. The LFCN passes the PM between the deep and the partially removed (b) superficial portion. Note the short distance between the GFN and the LST. British Journal of Anaesthesia 2014 112, 1098-1104DOI: (10.1093/bja/aet552) Copyright © 2014 The Author(s) Terms and Conditions

Fig 3 The GFN approaches the medial margin of the PM at L4/5 and runs parallel to the LST to the level of the vertebral body L3 and passes medially to the PM in the dorsal direction. The asterisk marks the GFN course according to the consulted literature. IVC, inferior vena cava; LST, lumbar sympathetic trunk. British Journal of Anaesthesia 2014 112, 1098-1104DOI: (10.1093/bja/aet552) Copyright © 2014 The Author(s) Terms and Conditions

Fig 4 The GFN approaches the LST at L3/4, runs along the LST to L2/3, and passes the PM medially at a L2. The LFCN runs along and enters the ventral face of the PM (similar to the topography of the GFN according to literature). IVC, inferior vena cava. British Journal of Anaesthesia 2014 112, 1098-1104DOI: (10.1093/bja/aet552) Copyright © 2014 The Author(s) Terms and Conditions

Fig 5 Boxplots of the distance measurements GFN–LST at levels L2/3, L3/4, and L4/5. British Journal of Anaesthesia 2014 112, 1098-1104DOI: (10.1093/bja/aet552) Copyright © 2014 The Author(s) Terms and Conditions