Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Jul;30(3):378-82.
doi: 10.4103/0970-9185.137271.

Prospective randomized comparison between ultrasound-guided saphenous nerve block within and distal to the adductor canal with low volume of local anesthetic

Areti Adoni  1 , Tilemachos Paraskeuopoulos  1 , Theodosios Saranteas  1 , Tatiana Sidiropoulou  1 , Dimitrios Mastrokalos  2 , Georgia Kostopanagiotou  1
Affiliations

Prospective randomized comparison between ultrasound-guided saphenous nerve block within and distal to the adductor canal with low volume of local anesthetic

Areti Adoni et al. J Anaesthesiol Clin Pharmacol. 2014 Jul.

Abstract

Background and aims: The anatomic site and the volume of local anesthetic needed for an ultrasound-guided saphenous nerve block differ in the literature. The purpose of this study was to examine the effect of two different ultrasound-guided low volume injections of local anesthetic on saphenous and vastus medialis nerves.

Materials and methods: Recruited patients (N = 48) scheduled for orthopedic surgery were randomized in two groups; Group distal adductor canal (DAC): Ultrasound-guided injection (5 ml of local anesthetic) distal to the inferior foramina of the adductor canal. Group adductor canal (AC): Ultrasound-guided injection (5 ml local anesthetic) within the adductor canal. Following the injection of local anesthetic, block progression was monitored in 5 min intervals for 15 min in the sartorial branches of the saphenous nerve and vastus medialis nerve.

Results: Twenty two patients in each group completed the study. Complete block of the saphenous nerve was observed in 55% and 59% in Group AC and DAC, respectively (P = 0.88). The proportion of patients with vastus medialis weakness at 15 min in Group AC, 36%, was significantly higher than in Group DAC (0/22), (P = 0.021).

Conclusions: Low volume of local anesthetic injected within the adductor canal or distally its inferior foramina leads to moderate success rate of the saphenous nerve block, while only the injection within the adductor canal may result in vastus medialis nerve motor block.

Keywords: saphenous nerve block; sonographic; vastus medialis.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Ultrasound-guided injection of local anesthetic within the distal part of the adductor canal. A = Femoral artery, S = Saphenous nerve, LA = Local anesthetic
Figure 2
Figure 2
Ultrasound-guided injection of local anesthetic at the compartment between the sartorius muscle and the femoral artery distal to the inferior foramina of the adductor canal. A = Femoral artery, V = Femoral vein, LA = Local anesthetic
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Benzon HT, Sharma S, Calimaran A. Comparison of the different approaches to saphenous nerve block. Anesthesiology. 2005;102:633–8. - PubMed
    1. van der Wal M, Lang SA, Yip RW. Transsartorial approach for saphenous nerve block. Can J Anaesth. 1993;40:542–6. - PubMed
    1. De Mey JC, Deruyck LJ, Cammu G, De Baerdemaeker LE, Mortier EP. A paravenous approach for the saphenous nerve block. Reg Anesth Pain Med. 2001;26:504–6. - PubMed
    1. Andersen HL, Gyrn J, Møller L, Christensen B, Zaric D. Continuous saphenous nerve block as supplement to single-dose local infiltration analgesia for postoperative pain management after total knee arthroplasty. Reg Anesth Pain Med. 2013;38:106–11. - PubMed
    1. Kent ML, Hackworth RJ, Riffenburgh RH, Kaesberg JL, Asseff DC, Lujan E, et al. A comparison of ultrasound-guided and landmark-based approaches to saphenous nerve blockade: A prospective, controlled, blinded, crossover trial. Anesth Analg. 2013;117:265–70. - PubMed