Regional anaesthesia for knee joint surgery – peripheral nerve blocks with minimal impact on motor function of the lower limb

Czech version

Authors: Ľ. Beňo
Authors‘ workplace: Klinika anesteziologie, perioperační a intenzivní medicíny, Fakulta zdravotnických studií, Univerzita J. E. Purkyně v Ústí nad Labem a Masarykova nemocnice v Ústí nad Labem
Published in: Anest. intenziv. Med., 29, 2018, č. 5, s. 265-268
Category:

Overview

This review describes the “femoral triangle” and “adductor canal” peripheral nerve blocks used for knee joint surgery. A significant advantage of these blockades is their preserving of the quadriceps motor function. This article shows how to distinguish the femoral triangle from the adductor canal and it explains the differences between them. It contains recent anatomical information from published cadaveric studies and it provides a simple guideline how to perform both techniques in clinical practice.

KEYWORDS

regional anaesthesia – peripheral nerve blocks – femoral triangle – adductor canal – quadriceps strength preservation – postoperative analgesia

Sources

1. Bendtsen TF, Moriggl B, Chan V, Borglum J. The optimal analgesic block for total knee arthroplasty. Reg Anesth Pain Med. 2016;41:711–719.

2. Orduña Valls JM, Vallejo R, López Pais P, et al. Anatomic and ultrasonographic evaluation of the knee sensory innervation: a cadaveric study to determine anatomic targets in the treatment of chronic knee pain. Reg Anesth Pain Med. 2017;42:90–98.

3. Wong WY, Bjorn S, Strid JM, et al. Defining the location of the adductor canal using ultrasound. Reg Anesth Pain Med. 2017;42:241–245.

4. Burckett-St Laurant D, Peng P, Giron Arango L, et al. The nerves of the adductor canal and the innervation of the knee: an anatomic study. Reg Anesth Pain Med. 2016;41:321–327.

5. Grevstad U, Mathiesen O, Valentiner LS, et al. Effect of adductor canal block versus femoral nerve block on quadriceps strength, mobilization, and pain after total knee arthroplasty, a randomized, blinded study. Reg Anesth Pain Med. 2015;40:3–10.

6. Sorensen JK, Jæger P, Dahl JB, et al. The isolated effect of adductor canal block on quadriceps femoris muscle strength after total knee arthroplasty: a triple-blinded, randomized, placebo-controlled trial with individual patient analysis. Anesthesia and Analgesia. 2016;122:553–558.

7. Abdallah FW, Whelan DB, Chan VW, et al. Adductor canal block provides noninferior analgesia and superior quadriceps strength compared with femoral nerve block in anterior cruciate ligament reconstruction. Anesthesiology 2016;124:1053–1064.

8. Runge C, Moriggl B, Borglum J, Bendtsen TF. The spread of ultrasound-guided injectate from the adductor canal to the genicular branch of the posterior obturator nerve and the popliteal plexus: A cadaveric study. Reg Anesth Pain Med. 2017;42:725–730.

Labels

Anaesthesiology, Resuscitation and Inten Intensive Care Medicine

The use of the pulmonary artery catheter in departments of cardiac surgery in the Czech and Slovak Republics – international questionnaire study

Effects of infusion solution on blood coagulation

Application of palliative care in intensive care medicine

Cytomegalovirus infection in intensive care. Treat or ignore them?

Using propofol − what is forbidden, is not (really) allowed ... or what are we risking if we use it in contradiction with the SPC?

Article was published in

Anaesthesiology and Intensive Care Medicine

2018 Issue 5