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Animals (Basel) 2022 Jun 14;12(12). Epub 2022 Jun 14.

Southern Counties Veterinary Specialists (SCVS), Forest Corner Farm, Hangersley, Hampshire, Ringwood BH24 3JW, UK.

The authors wish to make the following correction to this paper [... Read More

Pediatr Emerg Care 2022 May 25. Epub 2022 May 25.

From the Department of Pediatric Emergency Medicine, Medical University of South Carolina, Charleston, SC.

Abstract: The use of ultrasound-guided regional anesthesia is growing as a modality for analgesia provision within the pediatric emergency department. We present a case in which a paravenous saphenous nerve block was used for anesthesia during incision and drainage of a lower extremity abscess. We further review the technique and literature concerning this straightforward and effective procedure. Read More

Cureus 2022 May 16;14(5):e25060. Epub 2022 May 16.

Radiology, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi, IND.

Introduction Osteoarthritis (OA) of the knee is a common complaint in the elderly population and results in considerable disability in advanced stages. Though many pharmacological, electrotherapeutic, and interventional options are available for the effective treatment of knee OA in the early stages, these modalities fail to provide effective and long-term relief in some cases where peripheral nerve blocks may prove beneficial. Hence, this study was conducted to assess the efficacy of the saphenous nerve block in knee pain due to OA. Read More

BMC Musculoskelet Disord 2022 May 19;23(1):468. Epub 2022 May 19.

Department of Orthopedics, West China Hospital/West China School of Medicine, Sichuan University, 37# Wuhou Guoxue road, Chengdu, 610041, China.

Background: Local infiltration analgesia (LIA) and adductor canal block (ACB) provide postoperative analgesia for total knee arthroplasty (TKA). ACB blocks the saphenous nerve and has smaller impacts on quadriceps muscle weakness. ACB theoretically does not have enough analgesic effects on posterior sensory nerves. Read More

J Ultrasound 2022 Apr 23. Epub 2022 Apr 23.

Eastern Virignia Medical School, Department of Emergency Medicine, 600 Gresham Drive, Suite 304 Raleigh Building, Norfolk, VA, 23507, USA.

Acute limb ischemia (ALI) presents with significant pain that is often refractory to opioid pain management or is present in patients with relative contraindications to opioids. Here we present a case of ALI successfully managed with regional anesthesia using sciatic and saphenous nerve blocks. To our knowledge, this is the first case report of regional anesthesia for ALI performed in the Emergency Department (ED) by Emergency Medicine physicians. Read More

Asian J Surg 2022 Mar 14. Epub 2022 Mar 14.

Division of Vascular Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Electronic address:

Objective: To evaluate the benefit of ultrasound-guided femoral nerve block (UGFN) for reducing pain in patients undergoing radiofrequency ablation (RFA).

Methods: Patients age 18-70 years scheduled for RFA were prospectively enrolled. Patients were randomly assigned to the UGFN or control group at a 1:1 ratio, and stratified according to concomitant phlebectomy procedure. Read More

Clin Sports Med 2022 Apr;41(2):263-280

Department of Anesthesiology, University of Virginia Health, PO Box 800710, Charlottesville, VA 22908-0710, USA. Electronic address:

Modern anesthetic management for foot and ankle surgery includes a variety of anesthesia techniques including general anesthesia, neuraxial anesthesia, or MAC in combination with peripheral nerve blocks and/or multimodal analgesic agents. The choice of techniques should be tailored to the nature of the procedure, patient comorbidities, anesthesiologist skill level, intensity of anticipated postoperative pain, and surgeon preference. Read More

Cureus 2022 Feb 6;14(2):e21953. Epub 2022 Feb 6.

Anesthesiology and Perioperative Medicine, Ganga Medical Centre and Hospitals Pvt Ltd, Coimbatore, IND.

Below-knee surgeries are among the most commonly performed orthopedic or plastic and reconstructive procedures. They are associated with significant postoperative pain despite the use of systemic analgesics. The regional analgesia (RA) technique has been proven beneficial for better patient outcomes when used as an adjunct to multimodal analgesia in the early postoperative period. Read More

Anesth Essays Res 2021 Apr-Jun;15(2):208-212. Epub 2021 Dec 16.

Department of Anesthesia and Pain Management, King Hamad University Hospital, Al Sayh Bahrain, Bahrain.

Background: Postoperative pain relief after total knee arthroplasty (TKA) can be attained by using several techniques such as intravenous analgesia, epidural analgesia, and peripheral nerve blocks that include femoral nerve and saphenous nerve. Several authors recommended intra-articular injection of local anesthetic (IALA) as a part of multimodal analgesia regimens for TKA instead of other techniques.

Aims: The present study compares IALA technique efficacy with single-shot femoral nerve block (FNB) as part of multimodal analgesia regimen in TKA patients for postoperative pain management. Read More

Animals (Basel) 2022 03 1;12(5). Epub 2022 Mar 1.

Southern Counties Veterinary Specialists (SCVS), Forest Corner Farm, Hangersley, Hampshire, Ringwood BH24 3JW, UK.

Ultrasound-guided (US-guided) loco-regional anesthesia techniques allow direct visualization and blockade of sensory nerves. The saphenous nerve (SN), a terminal branch of the femoral nerve (FN), is strictly a sensory nerve for which electrical locator devices are ineffective for localization as no effector muscle contractions can be evoked. US-guided SN block in species other than rabbits produces hind-limb analgesia without affecting FN motor function. Read More

J Arthroplasty 2022 06 18;37(6S):S134-S138. Epub 2022 Feb 18.

Department of Orthopaedic Surgery, Virginia Tech Carilion Clinic, Roanoke, VA.

Background: The ultrasound-guided adductor canal block (High-ACB) is an effective option for pain control in total knee arthroplasty (TKA), but its use can add substantial cost and preparatory time to a TKA procedure. An intraoperative adductor canal block (Low-ACB) performed by the operative surgeon has been described as an alternative. The hypothesis of this study is that the Low-ACB would achieve noninferior pain control and opioid utilization postoperatively when compared to the High-ACB. Read More

World J Orthop 2022 Jan 18;13(1):11-35. Epub 2022 Jan 18.

Department of Anesthesiology, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140, United States.

Regional anesthesia is an integral component of successful orthopedic surgery. Neuraxial anesthesia is commonly used for surgical anesthesia while peripheral nerve blocks are often used for postoperative analgesia. Patient evaluation for regional anesthesia should include neurological, pulmonary, cardiovascular, and hematological assessments. Read More

World J Orthop 2021 Dec 18;12(12):1008-1015. Epub 2021 Dec 18.

The First Orthopaedic Department, Aristotle University of Thessaloniki, School of Medicine, Thessaloniki 57010, Greece.

Background: Development of infrapatellar saphenous neuroma (ISN) is a well-recognized reason for knee pain following total knee arthroplasty (TKA). So far, very few studies have addressed the development of painful ISN after TKA and its impact on functional outcome and patient satisfaction.

Aim: To present the results of surgical treatment for ISN after primary TKA, the level of pain relief, and the improvement of knee motion and function. Read More

J Pediatr Orthop 2022 Feb;42(2):e138-e142

Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD.

Background: Peripheral nerve blocks (PNBs) have recently been associated with a higher incidence of complications than previously thought. We compared: (1) incidence of PNB-related residual neurological symptoms and (2) patient selection, operative practices, and anesthesia practices for pediatric knee surgery patients before and after changes in PNB administration at our institution.

Methods: We compared data from pediatric patients who underwent knee surgery with PNBs from 2014 to 2016 (cohort 1; 100 patients) or 2017 to 2019 (cohort 2; 104 patients). Read More

Trials 2021 Nov 4;22(1):772. Epub 2021 Nov 4.

Department of Pain Management, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.

Background: Pain is common in the first 2 days after major craniotomy. Inadequate analgesia may lead to an increased risk of postoperative complications. Most pain following craniotomy arises from the pericranial muscles and soft tissues of the scalp. Read More

Minerva Anestesiol 2022 03 28;88(3):195-196. Epub 2021 Oct 28.

Department of Anesthesiology and Reanimation, Mugla Sitki Kocman University, Mugla, Turkey.

Vet Anaesth Analg 2021 Nov 30;48(6):962-971. Epub 2021 Aug 30.

Section of Veterinary Clinics and Animal Production, Department of Emergency and Organ Transplantation, Aldo Moro University, Bari, Italy. Electronic address:

Objective: To evaluate the effects of dexmedetomidine administered perineurally or intramuscularly (IM) on sensory, motor function and postoperative analgesia produced by lidocaine for sciatic and femoral nerve blocks in dogs undergoing unilateral tibial tuberosity advancement surgery.

Study Design: Prospective, blinded, clinical study.

Animals: A group of 30 dogs. Read More

Phys Med Rehabil Clin N Am 2021 11 14;32(4):791-801. Epub 2021 Jul 14.

Division of Anatomy, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Room 1158, Toronto, ON M5S 1A8, Canada.

In this article, the literature describing the origin, course, and termination of the nerves innervating the ankle joint is reviewed and discussed. The anterior aspect of the joint capsule receives innervation from articular branches from the saphenous, superficial, and deep fibular nerves; laterally from the sural and superficial fibular nerves; and medially and posteriorly from the saphenous and tibial nerves. Comprehensive mapping of the trajectory, spatial relationships, and termination of the articular branches innervating the ankle joint capsule will aid in developing new and improving existing image-guided nerve block and radiofrequency ablation protocols to treat chronic joint pain. Read More

Phys Med Rehabil Clin N Am 2021 11 14;32(4):767-778. Epub 2021 Jul 14.

Division of Anatomy, Department of Surgery, Temerty Faculty of Medicine, University of Toronto, 1 King's College Circle, Room 1158, Toronto, Ontario M5S 1A8, Canada.

Image-guided diagnostic block and radiofrequency ablation of the knee joint to manage pain require detailed understanding of joint innervation in relation to soft tissue and bony landmarks. In this article, the origin, course, and relationship to anatomic landmarks of articular nerves supplying the knee joint are discussed. The innervation pattern of the anterior and posterior aspects of the knee joint capsule is relatively consistent, with some variation in supply by the saphenous, anterior division of obturator, and common fibular nerves. Read More

Spine J 2022 02 31;22(2):296-304. Epub 2021 Jul 31.

Long Island Spine Specialists, Long Island, NY, USA; Northwell Health Huntington Hospital, Huntington, NY, USA.

Background Context: The transpsoas lateral lumbar interbody fusion (LLIF) technique is an effective alternative to traditional anterior and posterior approaches to the lumbar spine; however, nerve injuries are the most reported postoperative complication. Commonly used strategies to avoid nerve injury (eg, limiting retraction duration) have not been effective in detecting or preventing femoral nerve injuries.

Purpose: To evaluate the efficacy of emerging intraoperative femoral nerve monitoring techniques and the importance of employing prompt surgical countermeasures when degraded femoral nerve function is detected. Read More

Eur Radiol 2022 Feb 3;32(2):1342-1352. Epub 2021 Aug 3.

University Hospital Basel, Clinic of Radiology and Nuclear Medicine, University of Basel, Petersgraben 4, 4031, Basel, Switzerland.

Objectives: To evaluate the impact of diagnostic nerve block and ultrasound findings on therapeutic choices and predict the outcome after concomitant surgery in patients with suspected neuropathy of the infrapatellar branch of the saphenous nerve (IPBSN).

Methods: Fifty-five patients following knee surgery with suspicion of IPBSN neuralgia were retrospectively included. Ultrasound reports were assessed for neuroma and postsurgical scarring (yes/no). Read More

Arthroplast Today 2021 Aug 12;10:82-86. Epub 2021 Jul 12.

Department of Orthopaedics and Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand.

Background: Postoperative analgesia after knee arthroplasty forms a basis for an optimal range of motion after surgery. Femoral nerve blocks are established as a sensory nerve blockade but at the expense of quadriceps weakness delaying postoperative mobilization. The adductor canal block (ACB) similarly provides sensory blockade but preserves quadriceps function. Read More

J Med Case Rep 2021 Jul 15;15(1):378. Epub 2021 Jul 15.

Orthopaedic Associates of St. Augustine, One Orthopaedic Pl, St. Augustine, Jacksonville, FL, 32086, USA.

Background: Neuritis of the infrapatellar branch of the saphenous nerve can result from iatrogenic injury, entrapment, bursitis, or patellar dislocation. Currently, there is an unmet clinical need for treating refractory neuritis nonsurgically.

Case Presentation: Three patients presented with persistent anterior knee pain caused by neuritis of the infrapatellar branch of the saphenous nerve that had got excellent but only temporary relief from steroid and local anesthetic nerve block. Read More

Zhonghua Yi Xue Za Zhi 2021 Jun;101(21):1592-1597

Second Department of Orthopedics, Fujian Provincial Hospital, Fujian Medical University, Fuzhou 350001, China.

To report a method of visualized saphenous nerve block (VSNB) through minimally invasive far medial-subvastus approach distal to the adductor canal in total knee arthroplasty (TKA), and investigate the effect of VSNB in this way on postoperative pain relief. A total of 100 patients with knee osteoarthritis were prospectively included from June 2018 to October 2019, 29 males and 71 females, aged 50-87(70±8) years. All patients undergoing TKA through minimally invasive far medial-subvastus approach were randomized to visualized saphenous nerve block combined with periarticular infiltration analgesia group (Group VSNB+PIA) or only periarticular infiltration analgesia group (Group PIA),50 cases in each group. Read More

J Vasc Access 2021 Jun 6:11297298211023288. Epub 2021 Jun 6.

Department of Surgery, Saiwaicho Memorial Hospital, Okayama, Japan.

A superficialized artery as a blood-drawing route could be an option for vascular access (VA) in hemodialysis patients with cardiac failure, vessel damage, steal syndrome, and venous hypertension, and it could be a secondary VA option in those with repetitive vascular access troubles, routinely requiring a blood-returning venous route. The brachial artery is preferably used for superficialization due to the benefit of its appropriate diameter for cannulation, procedural ease of surgery under local anesthesia, and usable subcutaneous vein for blood-returning route in the upper limb. The superficial femoral artery (SFA) has also been reported as a candidate for arterial transposition; however, its subcutaneous transposition could have difficulties in requiring general anesthesia and securing blood-inflow-venous routes. Read More

Vet Anaesth Analg 2021 Jul 29;48(4):554-562. Epub 2021 Mar 29.

Anaesthesia Department, Anderson Moores Veterinary Specialists, Winchester, Hampshire, UK.

Objective: To retrospectively compare the efficacy and duration of effect of three commonly used locoregional blocks in dogs undergoing pelvic limb orthopaedic surgery.

Study Design: Retrospective clinical study.

Animals: A total of 236 dogs that underwent pelvic limb surgery and were administered a locoregional technique. Read More

Scand J Pain 2021 10 2;21(4):794-803. Epub 2021 Jun 2.

Orthopedic Anaestesia Department, Aalborg University Hospital, Aalborg, Denmark.

Objectives: Continuous peripheral nerve blocks (cPNBs) have shown promising results in pain management after orthopaedic surgeries. However, they can be associated with some risks and limitations. The purpose of this study is to describe our experience with the cPNBs regarding efficacy and adverse events in patients undergoing orthopedic surgeries on the lower extremity in different subspecialties. Read More

Can J Anaesth 2021 07 26;68(7):1028-1037. Epub 2021 May 26.

Department of Anesthesiology and Perioperative Medicine, Queen's University, Victory 2 Kingston General Hospital site, Kingston Health Sciences Centre, 76 Stuart Street, Kingston, ON, K7L 2V7, Canada.

Purpose: Postoperative analgesia following total knee arthroplasty (TKA) often includes intrathecal opioids, periarticular injection (PAI) of local anesthetic, systemic multimodal analgesia, and/or peripheral nerve blockade. The adductor canal block (ACB) provides analgesia without muscle weakness and magnesium sulphate (MgSO) may extend its duration. The purpose of this trial was to compare the duration and quality of early post-TKA analgesia in patients receiving postoperative ACB (± MgSO) in addition to standard care. Read More

Am J Vet Res 2021 Jun;82(6):449-458

Objective: To evaluate the effects of using ropivacaine combined with dexmedetomidine for sciatic and saphenous nerve blocks in dogs.

Animals: 7 healthy adult Beagles.

Procedures: In phase 1, dogs received each of the following 3 treatments in random order: perineural sciatic and saphenous nerve injections of 0. Read More

Pain Pract 2022 Jan 13;22(1):123-126. Epub 2021 Jun 13.

Department of Anesthesiology and Pain Medicine, College of Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Korea.

Complex regional pain syndrome is a painful and debilitating syndrome in which the patient presents with disabling pain, edema, and/or vasomotor or sudomotor abnormalities. The mechanism is complex and not well understood. There is no definitive treatment for the condition yet. Read More