Inter-fascial space between SArtorius muscle and FEmoral artery (ISAFE): A suggested approach for Adductor Canal catheter placement

Fernandes, Hermann dos Santos; Siddiqui, Naveed; Peacock, Sharon; Vidal, Ezequiel; Wolfstadt, Jesse; Gleicher, Yehoshua

doi:10.1016/j.jclinane.2021.110571

Journal of Clinical Anesthesia

2022

DOI: 10.1016/j.jclinane.2021.110571

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Inter-fascial space between SArtorius muscle and FEmoral artery (ISAFE): A suggested approach for Adductor Canal catheter placement

Hermann dos Santos Fernandes

Naveed Siddiqui

Sharon Peacock

et al.

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2023

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Cited by 2 publications

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“…We would also appreciate the authors’ opinion on whether or not strategies such as tunneling the catheter further inside the canal could potentially improve the clinical efficacy of cACB 3…”

mentioning

confidence: 99%

Questions remain about efficacy of adductor canal blocks

Gleicher

Fernandes

Peacock

et al. 2023

Reg Anesth Pain Med

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mentioning

confidence: 99%

Questions remain about efficacy of adductor canal blocks

Gleicher

Fernandes

Peacock

et al. 2023

Reg Anesth Pain Med

Self Cite

View full text Add to dashboard Cite

Comparison of migration rates between traditional and tunneled adductor canal block catheters: a randomized controlled trial

Gleicher,

dos Santos Fernandes,

Peacock

et al. 2023

Reg Anesth Pain Med

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IntroductionTotal knee arthroplasty is associated with significant postoperative pain. Continuous adductor canal blocks via an inserted adductor canal catheter are effective analgesia interventions with the advantage of decreasing quadriceps weakness and the potential of extending the analgesic effect. The classical adductor canal catheter insertion technique may have a high likelihood of catheter dislodgement out of the canal. The interfascial plane between the sartorius muscle and femoral artery (ISAFE) approach has the potential of decreasing the adductor canal catheter migration. The purpose of this study was to evaluate the incidence of catheter dislodgment to outside the adductor canal, for ISAFE and classical approaches. We hypothesized that ISAFE approach would result in a lower dislodgment rate.MethodsNinety-seven patients for unilateral total knee arthroplasty were included and randomized to either ISAFE intervention group or conventional group. The primary outcome was the incidence of adductor canal catheter dislodged to outside the adductor canal, on ultrasound evaluation, 24 hours after the surgery. Secondary outcomes were pain scores, opioid consumption and continuous adductor canal block related complications for the first 48 hours after surgery.ResultsThe catheters placed using ISAFE approach had a lower rate of dislodgement in comparison to the control group (18.6% vs 44.9%, respectively, p=0.01), at 24 hours after surgery; and lower pain scores for rest, on the first two postoperative days.ConclusionsISAFE group had a significantly lower rate of dislodgement at 24 hours. The continuous adductor canal block analgesic benefit for knee arthroplasty depends on the position of the tip of the catheter inside the adductor canal.

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Inter-fascial space between SArtorius muscle and FEmoral artery (ISAFE): A suggested approach for Adductor Canal catheter placement

Cited by 2 publications

References 10 publications

Questions remain about efficacy of adductor canal blocks

Questions remain about efficacy of adductor canal blocks

Comparison of migration rates between traditional and tunneled adductor canal block catheters: a randomized controlled trial

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