Ultrasound-guided infrapatellar nerve block in human volunteers: description of a novel technique †

Lundblad, M.; Kapral, Stephan; Marhofer, Peter; Lönnqvist, Per‐Arne

doi:10.1093/bja/ael241

Cited by 77 publications

(52 citation statements)

References 10 publications

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“…Trescot described the use of cryoneurolysis of the IPBSN for knee pain in 2003. In 2006, Lundblad [62] established a technique which utilized ultrasound to identify the IPBSN and inject levobupivacaine (Chirocaine, Abbott Scandinavia AB, Solna, Sweden) perineurally. The success rate was 90% and the duration of the block usually exceeded 16 h, which makes it potentially useful for postoperative analgesia for surgical procedures of the knee.…”

Section: Perioperative Treatment For Post-surgical Painmentioning

confidence: 99%

Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves

Ilfeld

Preciado

Trescot

2016

Expert Review of Medical Devices

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Introduction: Cryoneurolysis is the direct application of low temperatures to reversibly ablate peripheral nerves to provide pain relief. Recent development of a handheld cryoneurolysis device with small gauge probes and an integrated skin warmer broadens the clinical applications to include treatment of superficial nerves, further enabling treatments for pre-operative pain, post-surgical pain, chronic pain, and muscle movement disorders. Areas covered: Cryoneurolysis is the direct application of cold temperatures to a peripheral nerve, resulting in reversible ablation due to Wallerian degeneration and nerve regeneration. Use over the last 50 years attests to a very low incidence of complications and adverse effects. Cryoprobes have traditionally been applied through a surgical incision; but, recent technical advances allow percutaneous administration. A new hand-held device is now approved for use within the United States. Cryoneurolysis has been used to treat postoperative and chronic pain states as well as spasticity. Expert commentary: Changes in the US healthcare system such as a push for the reduction of opioid use and the incorporation of Diagnostic Related Group codes, as well as recent technological advances including a handheld unit that allows for treatment of superficial nerves while protecting the skin from damage, may contribute to the resurgence of cryoneurolysis for the treatment of peripheral nerves. ARTICLE HISTORY

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Section: Perioperative Treatment For Post-surgical Painmentioning

confidence: 99%

Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves

Ilfeld

Preciado

Trescot

2016

Expert Review of Medical Devices

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“…The development of ultrasound now allows us to perform the saphenous nerve block in the anteromedial thigh with very high success rates. The infrapatellar nerve, which innervates the peripatellar plexus of the knee [12] and includes the site where the patellar tendon is harvested, branches off from the saphenous nerve. Thus, anesthetizing the saphenous nerve and providing sensory nerve blockade to this area alone may allow effective supplementary postoperative analgesia.…”

Section: Introductionmentioning

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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“…A randomized prospective crossover trial of 30 volunteers showed that two US-guided approaches to SN block were substantially more successful (80-100 % loss of sensation to pinprick) than a below-theknee fi eld block (30 %) [ 46 ]. US guidance may also be useful for the IPS block [ 49 ]. In a prospective, double-blinded, randomized, placebo-controlled study comparing IPS blocks to placebo for knee arthroscopies, the femoral artery was used as a landmark to fi nd the SN (Fig.…”

Section: Sartorial Tendonitismentioning

confidence: 99%

Proximal Saphenous Nerve Entrapment: Thigh and Knee

Trescot

Karl

Brown³

et al. 2016

Peripheral Nerve Entrapments

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Ultrasound-guided infrapatellar nerve block in human volunteers: description of a novel technique †

Cited by 77 publications

References 10 publications

Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves

Novel cryoneurolysis device for the treatment of sensory and motor peripheral nerves

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

Proximal Saphenous Nerve Entrapment: Thigh and Knee

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