Anatomy and Clinical Implications of the Ultrasound-Guided Subsartorial Saphenous Nerve Block

Abstract

Ultrasound-guided injection directly caudally from the inferior foramina of the adductor canal, between the sartorius muscle and the femoral artery, seems to be an effective approach for saphenous nerve block.

Adductor Canal Block Can Result in Motor Block of the Quadriceps Muscle

“…9,10 The volume of the local anesthetic is also somewhat arbitrary, and a wide range (5-30 mL) has been used. 5,9,11,12 In our case, injection of 20 mL ropivacaine may have contributed to the proximal spread in the narrow adductor canal.…”

Pain After Unilateral Total Knee Arthroplasty: A Prospective Randomized Controlled Trial Examining the Analgesic Effectiveness of a Combined Adductor Canal Peripheral Nerve Block with Periarticular Infiltration Versus Adductor Canal Nerve Block Alone Versus Periarticular Infiltration Alone

“…The AC block has gained increasing popularity because of its potential analgesic efficacy and its potentially limited impact on motor function. 3,5,6,8,9 PI of local anesthetics is reported to be effective in reducing pain after TKA compared with placebo. 2,[10][11][12][13][14] In this trial, we compared 3 different methods of providing peripheral nerve block as part of an analgesic regimen that included a spinal anesthesia with intrathecal morphine and multimodal analgesics.…”

The Effects of Ultrasound-Guided Adductor Canal Block Versus Femoral Nerve Block on Quadriceps Strength and Fall Risk

“…We chose to do the study in volunteers to reliably assess motor strength without the potential confounders of pain, swelling, muscle spasm, or bandages present following knee surgery. 5,[20][21][22][23][24] Although it is difficult to assess analgesic efficacy in this model, it is ideal for the assessment of motor sparing and balance, and previous studies have assessed the analgesic efficacy of both ACBs 8,9 and FNBs. 1, 14 We used a reduction in quadriceps strength as confirmation of successful FNB as it is the most objective assessment tool and used sensory block for ACB as there is not an equivalent motor end point at this level.…”