Triple Nerve Block at the Knee for Foot and Ankle Surgery Performed by the Surgeon: Difficulties and Efficiency

Varitimidis, Sokratis; Venouziou, Aaron I.; Dailiana, Zoe; Christou, Dimitrios; Dimitroulias, Apostolos; Malizos, Konstantinos N.

doi:10.3113/fai.2009.0854

Cited by 19 publications

(16 citation statements)

References 18 publications

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“…While uncommon, these include allergic reactions to the anesthetic agent, vascular damage at the injection site, mechanical damage to the nerve at the injection site, and the risk of intravascular injection or hematoma. 2,4,7,19 There were 6 complications in total, 4 in the single-catheter group and 2 in the dual-catheter group. Four of the complications were neuritic in nature, and there were 2 in each group; 2 of these patients had improvement in their symptoms with time.…”

Section: Discussionmentioning

confidence: 98%

Combined Popliteal Catheter With Single-Injection vs Continuous-Infusion Saphenous Nerve Block for Foot and Ankle Surgery

et al. 2017

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Section: Discussionmentioning

confidence: 98%

Combined Popliteal Catheter With Single-Injection vs Continuous-Infusion Saphenous Nerve Block for Foot and Ankle Surgery

et al. 2017

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“…In orthopedic surgery, various anesthetic methods such as general, regional (epidural, spinal, intravenous, and peripheral nerve blocks) and local anesthesia are applied 1 , 2 , 3) . However, it has been reported that general or spinal anesthesia in lower extremity operation among advanced age patients lead to mortality in 15 of 10,000 patients and there is a possibility of various complications, such as postoperative pain, respiratory problems, headache, hypotension, and urinary retention 4) .…”

Section: Introductionmentioning

confidence: 99%

“…It is also an efficacious way for postoperative pain control and requires no fasting. Therefore, nerve block has acquired a larger role in orthopedic surgery 2 , 3) .…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of Ultrasound-Guided Lower Extremity Nerve Blockade in Surgery for Patellar Fracture

Kim

Kang

Joo

et al. 2015

Knee Surg Relat Res

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PurposeTo evaluate the usefulness of ultrasound-guided nerve blockade in patellar fracture surgery.Materials and MethodsTwenty-three patients who underwent metal fixation under ultrasound-guided lower extremity blockade after diagnosis of patellar fracture from July 2011 to June 2012 were enrolled in this study. Under ultrasound guidance, femoral nerve, lateral femoral cutaneous nerve, obturator nerve, and sciatic nerve blockades were performed. For evaluation of anesthesia, interference with overall surgery, such as intraoperative knee pain and tourniquet pain, was checked. Individual anesthetic complications, satisfaction with nerve blocks, and choice of future anesthesia method were investigated.ResultsNineteen patients underwent surgery without any pain and 4 patients with mild pain. Satisfaction was excellent in 17 patients, good in 5, and unsatisfactory in 1. No complications such as infection or nerve injury occurred. In terms of selection of future anesthesia, 22 patients chose a nerve blockade of the lower extremity under ultrasound guidance, and one chose general anesthesia.ConclusionsOverall, ultrasound-guided nerve block of the lower extremity for patellar fracture surgery showed satisfactory results. Therefore, it could be a useful method to prevent complications associated with general or spinal anesthesia.

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“…At the ankle, trauma of the sartorial branch due to arthroscopic portal placement has been reported (Ferkel et al, 1996). Blockade of this nerve combined with other nerves has also been done for ankle and foot surgery (Varitimidis et al, 2009). Therefore, knowledge of the anatomy of the sartorial branch is crucial to successful and safe surgical interventions.…”

Section: Introductionmentioning

confidence: 99%

Sartorial Branch of Saphenous Nerve: Anatomical Relationship with Bony Landmarks and Great Saphenous Vein

et al. 2013

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Sartorial branch of saphenous nerve (medial crural cutaneous nerve) originates at the medial side of the knee and descends along the great saphenous vein (GSV) to innervate the medial aspect of the leg. Its anatomy is of concern in surgical procedures and anesthetic block. However, the measurement data related to palpable bony landmarks with comparison between sexes and sides are lacking. Dissection was done in 95 lower limbs from both sexes. We found that the nerve pierced the deep fascia alone in most cases (92.6%). This piercing point was always distal to the adductor tubercle with the distance of 5-6 cm which was 15% of the leg length (the distance between the adductor tubercle and medial malleolus). The nerve was 7 cm medial to the tibial tuberosity. At the mid-level of leg length, the nerve was slightly over 4 cm medial to the anterior tibial margin. The nerve terminally divided 7 cm proximal to the medial malleolus. Furthermore, the anatomical relationship between the nerve and the GSV was highly variable. The nerve was constantly anterior, posterior or deep to the GSV in 8.4%, 15.8% and 2.1%, respectively. Crossing between the two structures was observed in 57.9% of specimens and the distance to the medial malleolus was 18 cm. Symmetry was found in most parameters and significant gender differences were observed in some distances. These results are important for avoiding the sartorial nerve injury and locating the nerve during relevant procedures.

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Triple Nerve Block at the Knee for Foot and Ankle Surgery Performed by the Surgeon: Difficulties and Efficiency

Cited by 19 publications

References 18 publications

Combined Popliteal Catheter With Single-Injection vs Continuous-Infusion Saphenous Nerve Block for Foot and Ankle Surgery

Combined Popliteal Catheter With Single-Injection vs Continuous-Infusion Saphenous Nerve Block for Foot and Ankle Surgery

Usefulness of Ultrasound-Guided Lower Extremity Nerve Blockade in Surgery for Patellar Fracture

Sartorial Branch of Saphenous Nerve: Anatomical Relationship with Bony Landmarks and Great Saphenous Vein

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