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J Clin Anesth 2018 Dec 12;54:160-161. Epub 2018 Dec 12.

Department of Anesthesiology, Perioperative, and Pain Medicine, Lucile Packard Children's Hospital Stanford, Palo Alto, CA, United States. Electronic address:

Acta Anaesthesiol Scand 2018 Nov 8. Epub 2018 Nov 8.

Department of Anaesthesiology, Herlev and Gentofte University Hospital, Herlev, Denmark.

Background: Peripheral nerve blocks (PNB) are increasingly used for anaesthesia and postoperative pain control in acute orthopaedic limb surgery but rebound pain upon cessation of PNBs may challenge the benefits on the pain profile. We aimed to explore the pain profile following acute ankle fracture surgery under PNB anaesthesia and investigate if rebound pain could pose a clinical problem.

Methods: Exploratory, observational study of adults scheduled for acute primary internal fixation of an ankle fracture under ultrasound-guided popliteal sciatic and saphenous ropivacaine block anaesthesia. Read More

Zhongguo Gu Shang 2018 Oct;31(10):907-911

Department of Anesthesiology, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China.

Objective: To explore clinical effects of ultrasound guided popliteal sciatic nerve combined saphenous nerve block in patients with anterior foot orthopedics.

Methods: From January 2017 to October 2017, 60 hallux valgus patients with metatarsophalangeal joint dislocation were randomly divided into experimental and control group according to random number table. Thirty patients in experimental group were treated by ultrasound guided popliteal sciatic nerve combined saphenous nerve block, including 13 males and 17 females, aged 31 to 76 years old with an average of (59. Read More

Orthop J Sports Med 2018 Oct 10;6(10):2325967118800948. Epub 2018 Oct 10.

Investigation performed at Unisports Sports Medicine, Auckland, New Zealand.

Background: For reconstruction of the anterior cruciate ligament (ACL) with hamstring autograft, perioperative analgesia can be achieved with multimodal analgesia and intra-articular local anesthesia infiltration with or without additional regional blocks. Saphenous nerve block (SNB) via the adductor canal is commonly used in our practice, but its benefit has not been well established in the literature.

Purpose: To assess the efficacy of SNB in ACL reconstruction with hamstring autograft. Read More

Surg Radiol Anat 2018 Nov 23;40(11):1267-1274. Epub 2018 Aug 23.

Department of Anatomy, Ankara University Faculty of Medicine, Ankara, Turkey.

Purpose: The aim of this study is to re-define the anatomical structures which are important for blocking the sciatic nerve and the nerves within the adductor canal which innervate the knee joint through the same injection site. We also aimed to investigate the spread of the anesthetic toward the areas in which the mentioned nerves lie on cadavers.

Methods: This study was performed on 16 lower extremities of formaldehyde-embalmed eight adult cadavers. Read More

J Int Med Res 2018 Oct 20;46(10):4207-4213. Epub 2018 Aug 20.

1 Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.

Objective This study aimed to identify the median effective volume of ropivacaine 0.5% for ultrasound-guided adductor canal block (ACB). Methods Thirty-two patients received ultrasound-guided ACB for knee arthroscopic meniscectomy. Read More

Vet Anaesth Analg 2018 Jul 29;45(4):566-574. Epub 2018 Mar 29.

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.

Objective: To evaluate an ultrasound-guided technique for adductor canal (AC) block by describing the distribution of methylene blue around the AC, popliteal fossa, saphenous, tibial and common fibular nerves in dog cadavers.

Study Design: Prospective experimental trial.

Animals: Ten mixed breed canine cadavers weighing 28. Read More

Curr Sports Med Rep 2018 May;17(5):146-147

Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL.

Foot Ankle Int 2018 05;39(5):638

Foot Ankle Int 2018 05;39(5):637

Reg Anesth Pain Med 2018 Jul;43(5):474-479

Department of Anesthesiology and Intensive Care Medicine, Kolding Hospital, Kolding, Denmark.

Background And Objectives: Major ankle surgery causes intense postoperative pain, and whereas the importance of a sciatic nerve block is well established, the clinical significance of a supplemental saphenous nerve block has never been determined in a prospective, randomized, double-blind, placebo-controlled trial. We hypothesized that a saphenous nerve block reduces the proportion of patients experiencing significant clinical pain after major ankle surgery.

Methods: Eighteen patients were enrolled and received a popliteal sciatic nerve block. Read More

Clin Orthop Relat Res 2018 Jan;476(1):37-39

E. Thienpont Saint Luc University Hospital, Department of Orthopaedic Surgery, Woluwe-Saint-Lambert, Brussels, Belgium.

Clin Orthop Relat Res 2018 Jan;476(1):30-36

J. J. Kavolus, D. E. Attarian, P. F. Lachiewicz Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA D. Sia, H. G. Potter, Department of Radiology and Imaging, MRI Research, Hospital for Special Surgery, New York, NY, USA.

Background: Surgeon-performed periarticular injections and anesthesiologist-performed femoral nerve or adductor canal blocks with local anesthetic are in common use as part of multimodal pain management regimens for patients undergoing TKA. However, femoral nerve blocks risk causing quadriceps weakness and falls, and anesthesiologist-performed adductor canal blocks are costly in time and resources and may be unreliable. We investigated the feasibility of a surgeon-performed saphenous nerve ("adductor canal") block from within the knee at the time of TKA. Read More

Clin Case Rep 2018 02 4;6(2):454-455. Epub 2018 Jan 4.

University of Medicine and Pharmacy "Iuliu Hațieganu" Cluj Napoca Cluj Napoca Romania.

Ultrasound-guided saphenous nerve block above the knee may be a valuable diagnosis tool in patient presenting chronic pain of the calf. Read More

Acta Anaesthesiol Scand 2018 Apr 20;62(4):548-557. Epub 2017 Dec 20.

Department of Anaesthesiology and Intensive Care Medicine, Aarhus University Hospital, Aarhus, Denmark.

Background: Major hindfoot and ankle surgery is associated with severe postoperative pain, which is effectively alleviated by combined sciatic and saphenous nerve blockade. Local anaesthetics with added dexamethasone consistently prolongs the duration of pain relief compared to local anaesthetics alone. However, whether the extended duration of pain relief is due to an effect on duration of sensorimotor block per se vs. Read More

Foot Ankle Int 2018 03 18;39(3):332-337. Epub 2017 Dec 18.

2 Rothman Institute Department of Orthopaedics, Thomas Jefferson University Hospital, Philadelphia, PA, USA.

Background: The increasing scope and complexity of foot and ankle procedures performed in an outpatient setting require more intensive perioperative analgesia. Regional anesthesia (popliteal and saphenous nerve blocks) has been proven to provide satisfactory pain management, decreased postoperative opioid use, and earlier patient discharge. This can be further augmented with the placement of a continuous-flow catheter, typically inserted into the popliteal nerve region. Read More

Reg Anesth Pain Med 2018 Jan;43(1):43-49

Background And Objectives: Obstructive sleep apnea is associated with increased complication rates postoperatively. Current literature does not provide adequate guidance on management of these patients. This study used the STOP-Bang questionnaire to diagnose patients with possible obstructive sleep apnea (score ≥3). Read More

J Orthop Surg Res 2017 Dec 4;12(1):188. Epub 2017 Dec 4.

Department of Orthopaedic Surgery, National University Health Systems (NUHS), 1E Kent Ridge Road, NUHS Tower Block Level 11, Singapore, 119228, Singapore.

Background: Bucket-handle meniscus tears (BHMT) are often displaced and unstable. The inside-out technique of repairing such tears is currently the gold standard. All-inside repair with meniscal fixators is getting increasingly popular. Read More

Reg Anesth Pain Med 2017 Nov/Dec;42(6):725-730

From the *Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark; †Division of Clinical and Functional Anatomy, Medical University of Innsbruck, Innsbruck, Austria; and ‡Department of Anesthesiology and Intensive Care Medicine, Zealand University Hospital, University of Copenhagen, Copenhagen; and §Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark.

Background And Objectives: The popliteal nerve plexus contributes to afferent knee-pain conduction. It is mainly formed by genicular branches from the posterior obturator and the tibial nerves, innervating the intra-articular and posterior knee region. A subinguinal obturator nerve block alleviates pain after total knee arthroplasty. Read More

Turk J Anaesthesiol Reanim 2017 Aug 1;45(4):218-224. Epub 2017 Aug 1.

Department of Anesthesiology, State University of New York At Buffalo, NY, USA.

Objective: To compare the analgesic effects of femoral nerve block (FNB) and adductor canal block (ACB) after arthroscopic knee surgery.

Methods: This was a prospective randomised clinical trial that enrolled 92 patients undergoing arthroscopic knee surgery. Ultrasound-guided FNB or ACB was performed immediately after surgery for pain relief. Read More

Vasc Health Risk Manag 2017 10;13:305-309. Epub 2017 Aug 10.

Division of Vascular Surgery, Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia.

Background: Endoluminal laser ablation is now considered the method of choice for treating greater saphenous vein insufficiency. General anesthesia and peripheral nerve blocks with sedation have the risk of post-procedural delay in discharge and prolonged immobilization with the risk of deep vein thrombosis. The main pain experienced by patients during the procedure is during the laser ablation and the multiple needle punctures given along and around the great saphenous vein. Read More

Saudi J Anaesth 2017 Jul-Sep;11(3):287-292

Department of Anesthesiology, The Ohio State University, Columbus, Ohio, USA.

Background And Objectives: Only a few different approaches are currently utilized for saphenous nerve block. Our study aimed to compare two different ultrasound (US)-guided saphenous nerve blocks and designed this study to test the hypothesis that the medial infracondylar approach has more success rate than the subsartorial approach applied in saphenous nerve blockage.

Methods: The study included 76 patients (18-65 years old) with the American Society of Anesthesiologists physical status of I-III, who were scheduled for below-knee surgery by the orthopedics clinic. Read More

Knee Surg Relat Res 2017 Jun;29(2):87-95

Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, Seoul, Korea.

Inadequate pain management after total knee arthroplasty (TKA) impedes recovery, increases the risk of postoperative complications, and results in patient dissatisfaction. Although the preemptive use of multimodal measures is currently considered the principle of pain management after TKA, no gold standard pain management protocol has been established. Peripheral nerve blocks have been used as part of a contemporary multimodal approach to pain control after TKA. Read More

J Neurosci 2017 05 24;37(20):5111-5122. Epub 2017 Apr 24.

Department of Biomedical Sciences, College of Osteopathic Medicine, Center for Excellence in the Neurosciences, University of New England, Biddeford, Maine 04005, and

Cancer-induced bone pain is characterized by moderate to severe ongoing pain that commonly requires the use of opiates. Even when ongoing pain is well controlled, patients can suffer breakthrough pain (BTP), episodic severe pain that "breaks through" the medication. We developed a novel model of cancer-induced BTP using female rats with mammary adenocarcinoma cells sealed within the tibia. Read More

Surg Radiol Anat 2017 Oct 29;39(10):1085-1095. Epub 2017 Mar 29.

Anatomy & Embryology Department, Faculty of Medicine, Mowasat Branch, Alexandria University, Elgamaa station, Alexandria, 21524, Egypt.

The precise description of the fascia vasto-adductoria (FVA) has become an issue of great surgical and clinical importance. Neurovascular entrapment within the adductor canal (AC) may simulate many clinical conditions for cases presented with medial knee or leg pain and ischemic manifestations of the leg. The aim of the present work is to describe the morphological features of the FVA and to elucidate its neurovascular relations. Read More

Am J Vet Res 2017 Apr;78(4):412-420

OBJECTIVE To evaluate the potential efficacy of blind perineural injection techniques to provide nerve blockade of the saphenous, obturator, and lateral cutaneous femoral nerves by assessing the distribution along those nerves of 3 volumes of an injected staining solution in dog cadavers. ANIMALS 18 canine cadavers. PROCEDURES The anatomic characteristics of the target nerves were evaluated by dissection in 3 cadavers. Read More

Osteoarthritis Cartilage 2017 08 20;25(8):1247-1256. Epub 2017 Mar 20.

Covina Arthritis Clinic, 500 W. San Bernardino Road, Suite A, Covina, CA 91722, USA.

Objective: Evaluate the efficacy and safety/tolerability of cryoneurolysis for reduction of pain and symptoms associated with knee osteoarthritis (OA).

Design: Randomized, double-blind, sham-controlled, multicenter trial with a 6-month follow-up in patients with mild-to-moderate knee OA. Patients were randomized 2:1 to cryoneurolysis targeting the infrapatellar branch of the saphenous nerve (IPBSN) or sham treatment. Read More

Skeletal Radiol 2017 Jun 16;46(6):795-803. Epub 2017 Mar 16.

Center for Musculoskeletal Care, New York University Langone Medical Center, New York, NY, USA.

Objective: To describe a 4-year clinical experience with ultrasound-guided therapeutic perineural injections of peripheral nerves about the foot and ankle.

Materials And Methods: Retrospective analysis of foot and ankle perineural injections performed between January 2012 and August 2016. Demographics, clinical indications, presence of structural pathology, immediate and interval pain relief, as well as complications were recorded. Read More

J Feline Med Surg 2017 Dec 10;19(12):1215-1223. Epub 2017 Feb 10.

5 Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.

Objectives Anatomical and methodological detail is lacking regarding local anesthetic peripheral nerve block techniques for distal pelvic limb surgery in cats. The aim of this study was to develop, describe and test nerve block methods based on cadaveric dissections and dye injections. Methods Ten pairs of feline pelvic limbs (n = 20) were dissected and the tibial nerve (T n. Read More

Res Vet Sci 2017 Dec 27;115:61-65. Epub 2017 Jan 27.

Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, QC, Canada.. Electronic address:

The objective of this study was to evaluate the distribution of bupivacaine hydrochloride using magnetic resonance imaging (MRI) after electrical nerve stimulator (ENS)-guided sciatic (ScN) and femoral (FN) nerve blocks in cats. Six adult cats (body weight 4.8±0. Read More

Reg Anesth Pain Med 2017 May/Jun;42(3):362-367

From the *Department of Anaesthesia, AZ Turnhout, Turnhout; †Department of Anaesthesia, University Hospital Antwerp, Antwerp; and ‡Department of Development and Regeneration, Jan Palfijn Anatomy Lab, University of Leuven Campus Kulak, Kortrijk, Belgium; §Department of Anaesthesia and Intensive Care, Philipps-University Hospital, Marburg, Germany; ∥Pain Centre, Department of Anesthesiology, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands; and #Anesthesiology ZOL, Genk; and **Department of Cardiovascular Sciences, KU Leuven and Department of Anaesthesiology, UZ Leuven, Leuven, Belgium.

Background And Objectives: Needle-induced nerve trauma and intraneural injection can lead to neurologic injury during peripheral nerve blocks. In this study, we assessed the utility of opening injection pressure (OIP), time to OIP, and rate of rise to OIP in detecting needle-nerve contact and intraneural injection.

Methods: Five common ultrasound-guided blocks of the femoral, saphenous, subgluteal sciatic, tibial, and common peroneal nerves were simulated in 10 fresh cadavers. Read More

J Clin Diagn Res 2016 Nov 1;10(11):TC13-TC17. Epub 2016 Nov 1.

Consultant Interventional and Cardiac Radiologist, Radiology, Ramesh Hospitals , Guntur, Andhra Pradesh, India .

Introduction: Laser ablation and sclerotherapy, as minimally invasive alternatives to surgery for varicose veins, have good efficacy, safety and cosmetic result. Some form of anaesthesia is generally used for pain control.

Aim: To describe the technique and evaluate the efficacy and safety of femoral, saphenous and sciatic nerve blocks in isolation or in combination for analgesia during laser ablation and sclerotherapy for lower limb varicose veins. Read More

Reg Anesth Pain Med 2017 Mar/Apr;42(2):210-216

From the *Department of Anesthesiology and Intensive Care Medicine, and †Department of Orthopedic Surgery, Aarhus University Hospital, Denmark; ‡Department of Anesthesiology and Intensive Care Medicine, Zealand University Hospital, University of Copenhagen, Denmark; and §Department of Anesthesiology, Kolding Hospital, Denmark.

Background And Objectives: Patients undergoing major elective ankle surgery often experience pain from the saphenous nerve territory persisting beyond the duration of a single-injection saphenous nerve block. We hypothesized that perineural dexamethasone as an adjuvant for the saphenous nerve block prolongs the duration of analgesia and postpones as well as reduces opioid-requiring pain.

Methods: Forty patients were included in this prospective, randomized, controlled study. Read More

Braz J Anesthesiol 2017 Jan - Feb;67(1):100-106. Epub 2016 Oct 26.

Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, Disciplina de Anestesiologia, Dor e Terapia Intensiva, São Paulo, SP, Brazil; Sociedade Brasileira de Anestesiologia, São Paulo, SP, Brazil.

Background And Objectives: The advent of ultrasound has brought many benefits to peripheral nerve blocks. It includes both safety and effectiveness, given the possibility of visualizing the neurovascular structures and the needle during the procedure. Despite these benefits, there is no consensus in the literature on the use of this technique in anticoagulated patients or with other coagulation disorders. Read More

Clin Ther 2017 01 10;39(1):89-97.e1. Epub 2016 Dec 10.

Department of Anaesthesiology, First Affiliated Hospital, Wenzhou Medical University, Zhejiang, China. Electronic address:

Purpose: A literature review of multiple clinical studies on mixing additives to improve pharmacologic limitation of local anesthetics during peripheral nerve blockade revealed inconsistency in success rates and various adverse effects. Animal research on dexmedetomidine as an adjuvant on the other hand has promising results, with evidence of minimum unwanted results. This randomized, double-blinded, contrastable observational study examined the efficacy of adding dexmedetomidine to a mixture of lidocaine plus ropivacaine during popliteal sciatic nerve blockade (PSNB). Read More

Reg Anesth Pain Med 2017 Jan/Feb;42(1):25-31

From the Department of Anesthesia, Division of Regional Anesthesia, St. Paul's Hospital; and Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, British Columbia, Canada.

Background And Objectives: Ultrasound-guided subsartorial saphenous nerve block is commonly used to provide complete surgical anesthesia of the foot and ankle in combination with a popliteal sciatic nerve block. However, in part owing to its small caliber and absence of a prominent vascular landmark in the subsartorial plane distal to the adductor canal, the saphenous nerve is more difficult to reliably block than the sciatic nerve in the popliteal fossa. Although the saphenous nerve is a sensory nerve only, neurostimulation can be used to elicit a "tapping" sensation on the anteromedial aspect of the lower leg extending toward the medial malleolus. Read More

Pain 2017 02;158(2):333-346

aDepartment of Anesthesia, Division of Pain Management, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA bDr. Liu is now with the Shaanxi University of Chinese Medicine, Xi'an, China cDepartment of Pediatrics, University of Cincinnati, Cincinnati, OH, USA.

Cutaneous inflammation alters the function of primary afferents and gene expression in the affected dorsal root ganglia (DRG). However, specific mechanisms of injury-induced peripheral afferent sensitization and behavioral hypersensitivity during development are not fully understood. Recent studies in children suggest a potential role for growth hormone (GH) in pain modulation. Read More

Minerva Anestesiol 2017 Feb 11;83(2):183-190. Epub 2016 Nov 11.

Department of Anesthesiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Background: Saphenous nerve block contributes to analgesia after knee and lower leg surgery. However, literature reports a wide range of volumes of local anesthetic being used for this block.

Methods: A non-randomized controlled trial in a single university hospital in March 2015. Read More

Br J Anaesth 2016 Nov;117(5):635-641

Department of Anaesthesia, Bispebjerg and Frederiksberg Hospitals, University of Copenhagen, Copenhagen, Denmark.

Background: Dexamethasone prolongs block duration. Whether this is achieved via a peripheral or a central mechanism of action is unknown. We hypothesized that perineural dexamethasone added as an adjuvant to ropivacaine prolongs block duration compared with ropivacaine alone, by a locally mediated effect when controlled for a systemic action. Read More

Anesthesiology 2017 01;126(1):66-73

From the Department of Anesthesiology, Zealand University Hospital, Køge, Denmark (J.H.A., O.M.); Department of Anesthesiology, Gentofte Hospital Kildegaardsvej Hellerup, Denmark (U.G.); Department of Anesthesiology, Nykøbing Falster Hospital, Nykøbing Falster, Denmark (H.S.); Department of Anesthesiology, Bispebjerg Hospital, Copenhagen NV, Denmark (J.B.D.); and Department of Anesthesiology, Centre of Head and Orthopedics, Rigshospitalet, Copenhagen East, Denmark (P.J.).

Background: Dexmedetomidine used as an adjuvant to local anesthetics may prolong the duration of peripheral nerve blocks. Whether this is mediated by a perineural or systemic mechanism remains unknown. The authors hypothesized that dexmedetomidine has a peripheral mechanism of action. Read More

Orthop Traumatol Surg Res 2016 12 26;102(8S):S251-S255. Epub 2016 Sep 26.

Hopital universitaire de la croix-rousse, Centre Albert-Trillat, 103, grande rue de la Croix-Rousse, 69004 Lyon, France.

Introduction: More and more anterior cruciate ligament (ACL) reconstructions are being performed as outpatient surgery in France, because of economic considerations. Postoperative pain is the most common reason for delayed discharge that could require hospitalization, and the main reason for unanticipated hospital admission. The purpose of this study was to define the best anesthesia and analgesia methods for ACL reconstruction. Read More

Foot Ankle Spec 2017 Apr 20;10(2):116-124. Epub 2016 Sep 20.

Royal North Shore Hospital, Reserve Road, Sydney, New South Wales, Australia (BR, KK, TB, JW, KF, AW).

Local anesthetic use for wound infusions, single injection, and continuous nerve blocks for postoperative analgesia is well established. No study has investigated the effect of a continuous block of the saphenous and superficial peroneal nerves at the level of the ankle joint following first ray surgery. A double blind randomized controlled trial was designed. Read More

Anesth Analg 2016 10;123(4):1026-32

From the *Department of Anaesthesia, Centre of Head and Orthopaedics, Copenhagen University Hospital, Rigshospitalet, Denmark; †Department of Anaesthesia and Intensive Care Medicine, Copenhagen University Hospital, Gentofte Hospital, Hellerup, Denmark; ‡Department of Anaesthesia and Intensive Care Medicine, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark; and §The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.

Background: The binary aims of this study were to investigate the effect of total dose of lidocaine on duration of an adductor canal block (ACB) and to validate different methods used to assess nerve blocks.

Methods: We performed 2 blinded, randomized, controlled crossover trials, including healthy, young men. In study 1, 14 subjects received 4 ACBs with saline and 40, 80, and 160 mg lidocaine. Read More

Knee Surg Sports Traumatol Arthrosc 2017 Apr 13;25(4):1298-1306. Epub 2016 Apr 13.

Department of Anesthesiology, Hospital for Special Surgery, New York, NY, USA.

Purpose: Subsartorial saphenous nerve blockade (SSNB) is an effective analgesic alternative to femoral nerve blockade after anterior cruciate ligament (ACL) reconstruction with bone-tendon-bone (BTB) autograft. It was hypothesized that dexamethasone in a SSNB will prolong analgesia, improve pain and satisfaction, and reduce postoperative opioid requirements and side effects.

Methods: One hundred ninety-five patients undergoing ACL reconstruction with BTB autograft (ages 16-65) were enrolled. Read More

Rev Bras Anestesiol 2017 Jan - Feb;67(1):100-106. Epub 2016 Mar 23.

Universidade Federal de São Paulo (Unifesp), Escola Paulista de Medicina, Disciplina de Anestesiologia, Dor e Terapia Intensiva, São Paulo, SP, Brasil; Sociedade Brasileira de Anestesiologia, São Paulo, SP, Brasil.

Background And Objectives: The advent of ultrasound has brought many benefits to peripheral nerve blocks. It includes both safety and effectiveness, given the possibility of visualizing the neurovascular structures and the needle during the procedure. Despite these benefits, there is no consensus in the literature on the use of this technique in anticoagulated patients or with other coagulation disorders. Read More

Reg Anesth Pain Med 2016 May-Jun;41(3):321-7

From the *Department of Anaesthesia, University Hospital of Wales, Cardiff, United Kingdom; †Department of Anesthesia, University of Toronto; ‡Department of Anesthesia, University Health Network, Toronto, Ontario, Canada; §Department of Anesthesia, Universidad CES, Medellin, Colombia; and ∥Department of Anatomy, University of Toronto, Toronto, Ontario, Canada.

Background And Objectives: Adductor canal block contributes to analgesia after total knee arthroplasty. However, controversy exists regarding the target nerves and the ideal site of local anesthetic administration. The aim of this cadaveric study was to identify the trajectory of all nerves that course in the adductor canal from their origin to their termination and describe their relative contributions to the innervation of the knee joint. Read More

Anesth Analg 2016 May;122(5):1696-703

From the Departments of *Anesthesiology and Critical Care, †Orthopedic Surgery, and ‡Physical Therapy and Rehabilitation, University of Pennsylvania, Philadelphia, Pennsylvania; §Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, California; and ∥Anesthesiology and Perioperative Care Service, VA Palo Alto Health Care System, Palo Alto, California.

Background: Adductor canal block (ACB) has emerged as an appealing alternative to femoral nerve block (FNB) that produces a predominantly sensory nerve block by anesthetizing the saphenous nerve. Studies have shown greater quadriceps strength preservation with ACB compared with FNB, but no advantage has yet been shown in terms of fall risk. The Tinetti scale is used by physical therapists to assess gait and balance, and total score can estimate a patient's fall risk. Read More