Special techniquesfor ultrasound-guided peripheralnerve blocks in anaesthesiology-Saphenous nerve block

Doctoral Dissertation uoadl:1306108 561 Read counter

Unit:
Τομέας Χειρουργικής
Library of the School of Health Sciences
Deposit date:
2013-03-13
Year:
2013
Author:
Αναγνώστης Γεώργιος
Dissertation committee:
Αναπληρώτρια Καθηγήτρια Αναγνωστοπούλου Σοφία (επιβλέπουσα), Επίκουρος Καθηγήτρια Ματσώτα Παρασκευή, Λέκτορας Σαραντέας Θεοδόσιος
Original Title:
Ειδικές υπερηχογραφικές τεχνικές για τον αποκλεισμό περιφερικών νεύρων στην αναισθησιολογία-σαφηνές νεύρο
Languages:
Greek
Translated title:
Special techniquesfor ultrasound-guided peripheralnerve blocks in anaesthesiology-Saphenous nerve block
Summary:
Background: We evaluated the anatomic basis and the clinical results
of an ultrasound-guided saphenous nerve block close to the level of the
nerve’s exit from the inferior foramina of the adductor canal.
Methods: The anatomic study was conducted in 11 knees of formalin preserved
cadavers in which the saphenous nerve was dissected from
near its exit from the inferior foramina of the adductor canal. The clinical
study was conducted in 23 volunteers. Using a linear probe, the femoral
vessels and the sartorius muscle were depicted in short-axis view at the
level where the saphenous nerve exits the inferior foramina of the adductor
canal. Ten milliliters of 1.5% lidocaine was injected into the
compartment structured by the sartorius muscle and the femoral artery.
Results: The saphenous nerve was found to exit the adductor canal
from its inferior foramina in 9 (81.8%) of 11 and at a more proximal level
in 2 (18.2%) of 11 of the anatomic specimens. In a single specimen (9%),
the saphenous nerve was formed by the anastomosis of 2 branches. In all
the dissections, the saphenous nerve, after exiting the adductor canal,
passed between the sartorius muscle and the femoral artery. Of the 23
volunteers, 22 responded with a complete sensory block, whereas a single
volunteer demonstrated no sensory blockade. None of the volunteers
experienced a motor block of the hip flexors and knee extensors.
Conclusions: 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.
Keywords:
Saphenous nerve anatomy, Ultrasounds, Regional anaesthesia, Ultrasound-guided peripheral nerve blocks, Orthopedic surgery
Index:
Yes
Number of index pages:
0
Contains images:
Yes
Number of references:
111
Number of pages:
184
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