Accuracy of ultrasound-guided localization of the peripatellar plexus for knee pain management

McCumber, Travis; Cassidy, Keely; Latacha, Kimberly; Simet, Samantha M.; Vilburn, Matthew; Urban, Nathanael D.; Vogt, C.; Urban, Joshua A.

doi:10.1016/j.jclinane.2019.04.005

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…Current studies of PP focusing on either anatomy or ultrasound have examined only some of the four nerves of PP and have fallen short in terms of details, impeding the development and clinical application of PP block. A cadaver study under ultrasound confirmed the feasibility of block for several PP branches, but this study demonstrated a poor success rate with IPBSN block and did not provide details on identifying among the MFCN, IFCN I and IFCN II under ultrasound [ 25 ]. Another cadaveric study under ultrasound identified only the MFCN and one branch of the IFCN, with no detailed identification of the PP branches [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Motor-sparing peripatellar plexus block provides noninferior block duration and complete block area of the peripatellar region compared with femoral nerve block: a randomized, controlled, noninferiority study

Gong¹,

Zhang

et al. 2022

BMC Anesthesiol

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Background Developing adequate regional anaesthesia for knee surgeries without affecting lower limb mobilization is crucial to perioperative analgesia. However, reports in this regard are limited. We proposed a technique for ultrasound-guided peripatellar plexus (PP) block. Compared with the femoral nerve (FN) block, we hypothesized that this technique would provide a noninferior block duration and a complete cutaneous sensory block in the peripatellar region without affecting lower limb mobilization. An investigation was conducted to verify our hypothesis in cadavers and volunteers. Methods The study was designed in two parts. First, eight cadaveric lower limbs were dissected to verify the feasibility of PP block after methylene blue injection under ultrasound. Second, using a noninferiority study design, 50 healthy volunteers were randomized to receive either a PP block (PP group) or an FN block (FN group). The primary outcome was the duration of peripatellar cutaneous sensory block, with the prespecified noninferiority margin of -3.08 h; the secondary outcome was the area of peripatellar cutaneous sensory block; in addition, the number of complete anaesthesias of the incision line for total knee arthroplasty and the Bromage score 30 min after block were recorded. Results The PP was successfully dyed, whereas the FN and saphenous nerve were unstained in all cadaveric limbs. The mean difference of the block duration between the two groups was − 1.24 (95% CI, -2.81 − 0.33) h, and the lower boundary of the two-sided 95% CI was higher than the prespecified noninferiority margin (Pnoninferiority = 0.023), confirming the noninferiority of our technique over FN block. The cutaneous sensory loss covered the entire peripatellar region in the PP group. PP block achieved complete anaesthesia of the incision line used for total knee arthroplasty and a Bromage score of 0 in 25 volunteers, which differed significantly from that of volunteers who underwent FN block. Conclusion Ultrasound-guided PP block is a feasible technique. Compared with FN block, PP block provides noninferior block duration and complete blocking of the peripatellar region without affecting lower limb mobilization. Trial registration This study was registered in the Chinese Clinical Trial Register (registration no. ChiCTR2000041547, registration date 28/12/2020).

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Section: Discussionmentioning

confidence: 99%