Sonography for Saphenous Nerve Block Near the Adductor Canal

Krombach, Jens; Gray, Andrew T.

doi:10.1016/j.rapm.2007.04.006

Cited by 31 publications

(21 citation statements)

References 5 publications

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“…For comparison, patients were divided into 2 groups. Patients in the ACB group received a preoperative ultrasound-guided single-shot ACB, as previously described [22,23], with 15 to 30 cc of 0.5% bupivacaine. At the time these procedures were performed, the standard of care for postoperative analgesia for a TKA included an FNB.…”

Section: Methodsmentioning

confidence: 99%

The adductor canal block provides effective analgesia similar to a femoral nerve block in patients undergoing total knee arthroplasty—a retrospective study

Patterson

Bland

Thomas

et al. 2015

Journal of Clinical Anesthesia

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Section: Methodsmentioning

confidence: 99%

The adductor canal block provides effective analgesia similar to a femoral nerve block in patients undergoing total knee arthroplasty—a retrospective study

Patterson

Bland

Thomas

et al. 2015

Journal of Clinical Anesthesia

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“…At this point, the saphenous nerve was identified as it continued in its original course just underneath the sartorius muscle. At a distance of no more than 7 cm proximal to the medial condyle [11], a short axis view of the sartorius and vastus medialis muscles was obtained with the saphenous nerve identified between the two muscles [13] (Fig. 1a, b).…”

Section: Methodsmentioning

confidence: 99%

Postoperative Analgesia with Saphenous Block Appears Equivalent to Femoral Nerve Block in ACL Reconstruction

Chisholm

Bang

Maalouf

et al. 2014

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Adequate pain control following anterior cruciate ligament reconstruction (ACL) often requires regional nerve block. The femoral nerve block (FNB) has been traditionally employed. Ultrasound application to regional nerve blocks allows for the use of alternatives such as the saphenous nerve block following ACL reconstruction. Questions/Purposes: This study evaluated postoperative analgesia provided by the subsartorial saphenous nerve block (SSNB) compared to that provided by the traditional FNB for patients undergoing ACL reconstruction with patellar tendon (bone-tendon-bone (BTB)) autografts. Methods: A randomized, blinded, controlled clinical trial was conducted using 80 ASA I-III patients, ages 16-65, undergoing ACL reconstruction with BTB. The individuals assessing all outcome measures were blinded to the treatment group. Postoperatively, all patients received cryotherapy and parenteral hydromorphone to achieve numeric rating scale pain scores less than 4. At discharge, patients were given prescriptions for oral opioid analgesics and a scheduled NSAID. Patients were instructed to complete pain diaries and record oral opioid utilization. Patients were contacted on postoperative days (POD) 1 and 2 to ascertain the level of patient satisfaction with the analgesic regimen. Results: No differences between the two groups were found. Patient demographics and postoperative pain scores at rest were not different. In addition, there was no difference in opioid use, as measured in daily oral morphine equivalents between groups. A small but statistically significant report of higher patient satisfaction with the FNB was found on POD 1 but not on POD 2. Conclusion: These data support our hypothesis that the SSNB provides similar and adequate postoperative analgesia when compared to the FNB, following arthroscopic ACL reconstruction with patellar tendon autograft.

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“…Previously described ultrasound-guided techniques have focused on blocking the saphenous nerve within the adductor canal or distal to it. [4][5][6][7] On the other hand, our technique initially involves identifying the femoral artery at the mid-thigh level as the surrogate landmark, and then identifying the nerve bundle in proximity to the femoral nerve. At this subsartorial location, the saphenous nerve may run with at least two additional nerves, the infrapatellar nerve 11 and the nerve to the vastus medialis.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of an ultrasound-guided subsartorial approach to saphenous nerve block: a case series

Tsai

Karnwal

Kakazu

et al. 2010

Can J Anesth/J Can Anesth

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Purpose The saphenous nerve, a branch of the femoral nerve, is a pure sensory nerve that supplies the anteromedial aspect of the lower leg from the knee to the foot. There is limited evidence of the effectiveness of ultrasoundguided techniques to block the saphenous nerve. We therefore undertook a retrospective case series to investigate the efficacy of an ultrasound-guided subsartorial approach to saphenous nerve block. Methods During a four-month period, all patients receiving a subsartorial saphenous nerve block for lower extremity surgery at our institution had their medical records reviewed. Patient demographics and data were recorded, including block characteristics, intraoperative anesthetic management, pre-block, post-block, and postoperative pain scores, as well as postoperative analgesic dosing. Preoperative block success was defined by minimal intraoperative analgesic administration and a pain score of 0 in the postanesthesia care unit not requiring analgesic supplementation. Postoperative block success was defined by reduction of pain score to 0 without need for additional analgesic dosing. Results Thirty-nine consecutive patients were identified as receiving an ultrasound-guided subsartorial saphenous nerve block. Overall, this ultrasound-guided technique was found to have a 77% success rate.Conclusion This case series shows that an ultrasoundguided subsartorial approach to saphenous nerve blockade is a moderately effective means to anesthetize the anteromedial lower extremity. The success rate is based on stringent criteria with an endpoint of postoperative analgesia. A randomized prospective study would provide a more definitive answer regarding the efficacy of this technique for surgical anesthesia. RésuméObjectif Le nerf saphe`ne interne, une branche du nerf fe´moral, est un nerf purement sensitif qui innerve la partie ante´rome´diale de la jambe, du genou jusqu'au pied. Il existe peu de preuves quant a`l'efficacite´des techniques guide´es par ultrason pour l'anesthe´sie du nerf saphe`ne interne. Nous avons donc entrepris une revue re´trospective d'une se´rie de cas afin d'examiner l'efficacite´d'une approche sous-sartoriale guide´e par ultrason pour l'anesthe´sie du nerf saphe`ne interne. Méthodes Pendant une pe´riode de quatre mois, les dossiers me´dicaux de tous les patients ayant be´ne´ficie´d'un bloc sous-sartorial du nerf saphe`ne interne pour une chirurgie du membre infe´rieur a`notre institution ont e´teŕ evus. Les donne´es de´mographiques et des renseignements sur ces patients ont e´te´recueillis, dont les caracte´ristiques du bloc, la prise en charge de l'anesthe´sie perope´ratoire, les scores de douleur pre´-anesthe´sie, postanesthe´sie et postope´ratoire, ainsi que la posologie analge´sique postope´ratoire. La re´ussite du bloc en pe´riode pre´ope´ratoire a e´te´de´finie par une administration perope´ratoire minime de substances analge´siques et un score de douleur a`0 ne nécessitant aucun apport analge´sique supple´mentaire a`la salle de re´veil. La re´ussite du bloc en pe´r...

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Sonography for Saphenous Nerve Block Near the Adductor Canal

Cited by 31 publications

References 5 publications

The adductor canal block provides effective analgesia similar to a femoral nerve block in patients undergoing total knee arthroplasty—a retrospective study

The adductor canal block provides effective analgesia similar to a femoral nerve block in patients undergoing total knee arthroplasty—a retrospective study

Postoperative Analgesia with Saphenous Block Appears Equivalent to Femoral Nerve Block in ACL Reconstruction

Efficacy of an ultrasound-guided subsartorial approach to saphenous nerve block: a case series

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