Adductor Canal Block—or Subsartorial Canal Block?

Cowlishaw, Phillip; Kotze, Paulo Gustavo

doi:10.1097/aap.0000000000000205

Cited by 20 publications

(19 citation statements)

References 8 publications

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“…Our findings of reduced proximal spread of AC injectate into the distal FT are consistent with previous cadaveric studies. Dissections by Cowlishaw and Kotze26 and Ishiguro et al 27 also demonstrated limited cephalad spread from the AC into the FT with consequent sparing of femoral nerve branches to sartorius, rectus femoris and vastus lateralis.…”

Section: Discussionmentioning

confidence: 97%

Spread of dye injectate in the distal femoral triangle versus the distal adductor canal: a cadaveric study

Johnston

Black

Cowden

et al. 2019

Regional Anesthesia &Amp; Pain Medicine

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Background and objectivesThe nerve to vastus medialis (NVM) supplies sensation to important structures relevant to total knee arthroplasty via a medial parapatellar approach. There are opposing findings in the literature about the presence of the NVM within the adductor canal (AC). The objective of this cadaveric study is to compare the effect of injection site (distal femoral triangle (FT) vs distal AC) on injectate spread to the saphenous nerve (SN) and the NVM.MethodsFour unembalmed fresh-frozen cadavers acted as their own control with one thigh receiving 20 mL of dye injected via an ultrasound-guided injection in the distal FT while the other thigh received an ultrasound-guided injection in the distal AC. A standardized dissection took place 1 hour later to observe the extent of staining to the NVM and SN in all cadaver thigh specimens.ResultsIn all specimens where the injectate was introduced into the distal FT, both the SN and NVM were stained. In contrast, when the dye was administered in the distal AC only the SN was stained.ConclusionsOur findings suggest that an injection in the distal AC may be suboptimal for knee analgesia as it may spare the NVM, while an injection in the distal FT could provide greater analgesia to the knee but may result in undesirable motor blockade from spread to the nerve to vastus intermedius.

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Section: Discussionmentioning

confidence: 97%

Spread of dye injectate in the distal femoral triangle versus the distal adductor canal: a cadaveric study

Johnston

Black

Cowden

et al. 2019

Regional Anesthesia &Amp; Pain Medicine

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“…Overlying the VAM is the sartorius muscle; hence the block has also been referred to as subsartorial block. As the sartorius muscle extends both proximally and distally beyond the adductor canal, this may not be the correct nomenclature to use for the adductor canal block [24,25].…”

Section: Adductor Canal Blockmentioning

confidence: 98%

“…There has been debate in recent literature about the nomenclature of the block, the best site of injection and method of identification of this site [25]. Bendtsen and colleagues defined the boundaries of the adductor canal and emphasized that these should be identified with the ultrasound rather than surface landmarks [24].…”

Section: Adductor Canal Blockmentioning

confidence: 99%

Recent advances in regional anaesthesia

Chhabra

2016

Trends in Anaesthesia and Critical Care

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“…Regardless of the exact definition, anatomical studies support that subsartorial injection close to the femoral triangle has minimal cephalad spread. 46,47 Although early descriptions of a subsartorial block with the use of a twitch monitor exist, it has become exclusively a USG block. 48 Because of the location of the nerve relative to the artery, the approach typically described is an in-plane anterolateral to medial approach, with the ultrasound probe positioned mid-thigh.…”

Section: Anatomy and Techniquementioning

confidence: 99%

Update on emerging regional techniques and novel local anesthetics in ambulatory anesthesia

Szafran¹,

Abrahams²,

Gan

2015

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New regional anesthetic techniques have been incorporated into the multimodal approach to postoperative analgesia. Blocks such as the transversus abdominis plane block, adductor canal block, and pectoral nerves blocks all show promise as potential tools used in opioid-sparing techniques, but at the same time have significant limitations to their utility. Novel long-acting formulations of local anesthetics further add to the possible benefit of these blocks, but their application to peripheral nerve blocks is currently being investigated and is not well defined. This review focuses on evaluating the relevant anatomy, technique, and indications of several newer peripheral nerve blocks, the emerging evidence supporting the use of liposomal bupivacaine and SABER ® -Bupivacaine, and the application of both in ambulatory anesthesia.

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Adductor Canal Block—or Subsartorial Canal Block?

Cited by 20 publications

References 8 publications

Spread of dye injectate in the distal femoral triangle versus the distal adductor canal: a cadaveric study

Spread of dye injectate in the distal femoral triangle versus the distal adductor canal: a cadaveric study

Recent advances in regional anaesthesia

Update on emerging regional techniques and novel local anesthetics in ambulatory anesthesia

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