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A comparison of ultrasound-guided and landmark-based approaches to saphenous nerve blockade: a prospective, controlled, blinded, crossover trial.

Publication ,  Journal Article
Kent, ML; Hackworth, RJ; Riffenburgh, RH; Kaesberg, JL; Asseff, DC; Lujan, E; Corey, JM
Published in: Anesth Analg
July 2013

BACKGROUND: Blockade of the saphenous nerve is often used for surgeries below the knee. Depending on the approach, success rates vary widely ranging from 33% to 88%. In this prospective volunteer study, we compared 2 ultrasound-guided techniques, the modified vastus medialis and perifemoral saphenous nerve block with a below the knee field block. METHODS: Twenty volunteer adults, in a single-blinded, crossover, prospective trial underwent 3 different saphenous nerve blocks. The primary end point of block success was loss of sensation in the distal two-thirds distribution of the saphenous nerve. Secondary variables included time to perform the block, time to sensory loss, pain during block, and motor weakness. RESULTS: Compared with the below the knee field block success rate (30%), both the modified vastus medialis and perifemoral techniques had significantly higher success rates (80%, difference 50% with confidence interval [CI], 23%-77%, P = 0.009, and 100%, difference 70% with CI, 41%-91%, P < 0.001, respectively). However, the difference when comparing the perifemoral ultrasound technique against the modified vastus medialis ultrasound technique did not show significance (difference 20% with CI, -7% to 49%, P = 0.125). Also, no statistical differences were found with the other variables measured, except the perifemoral technique showed faster block performance times than below the knee field block (P = 0.007). CONCLUSION: In our prospective study, we have demonstrated that ultrasound-guided above the knee saphenous nerve blocks have higher success rates than a below the knee field block and are easily performed in a short amount of time.

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Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

July 2013

Volume

117

Issue

1

Start / End Page

265 / 270

Location

United States

Related Subject Headings

  • Ultrasonography, Interventional
  • Single-Blind Method
  • Prospective Studies
  • Peripheral Nerves
  • Male
  • Humans
  • Cross-Over Studies
  • Autonomic Nerve Block
  • Anesthesiology
  • Adult
 

Citation

APA
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Kent, M. L., Hackworth, R. J., Riffenburgh, R. H., Kaesberg, J. L., Asseff, D. C., Lujan, E., & Corey, J. M. (2013). A comparison of ultrasound-guided and landmark-based approaches to saphenous nerve blockade: a prospective, controlled, blinded, crossover trial. Anesth Analg, 117(1), 265–270. https://doi.org/10.1213/ANE.0b013e3182908d5d
Kent, Michael L., Robert J. Hackworth, Robert H. Riffenburgh, Julie L. Kaesberg, David C. Asseff, Eugenio Lujan, and John M. Corey. “A comparison of ultrasound-guided and landmark-based approaches to saphenous nerve blockade: a prospective, controlled, blinded, crossover trial.Anesth Analg 117, no. 1 (July 2013): 265–70. https://doi.org/10.1213/ANE.0b013e3182908d5d.
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 Jul;117(1):265–70.
Kent, Michael L., et al. “A comparison of ultrasound-guided and landmark-based approaches to saphenous nerve blockade: a prospective, controlled, blinded, crossover trial.Anesth Analg, vol. 117, no. 1, July 2013, pp. 265–70. Pubmed, doi:10.1213/ANE.0b013e3182908d5d.
Kent ML, Hackworth RJ, Riffenburgh RH, Kaesberg JL, Asseff DC, Lujan E, Corey JM. A comparison of ultrasound-guided and landmark-based approaches to saphenous nerve blockade: a prospective, controlled, blinded, crossover trial. Anesth Analg. 2013 Jul;117(1):265–270.

Published In

Anesth Analg

DOI

EISSN

1526-7598

Publication Date

July 2013

Volume

117

Issue

1

Start / End Page

265 / 270

Location

United States

Related Subject Headings

  • Ultrasonography, Interventional
  • Single-Blind Method
  • Prospective Studies
  • Peripheral Nerves
  • Male
  • Humans
  • Cross-Over Studies
  • Autonomic Nerve Block
  • Anesthesiology
  • Adult