Adductor canal block with a suture-method catheter - A parallel or perpendicular approach?

Area of Science:

• Anesthesiology
• Pain Management
• Regional Anesthesia

Background:

• Adductor canal blocks are crucial for knee surgery anesthesia.
• Suture-method catheters offer potential for prolonged analgesia.
• Feasibility of adductor canal catheterization requires evaluation.

Purpose of the Study:

• To assess the feasibility of placing suture-method catheters in the adductor canal.
• To compare two different insertion techniques: parallel and perpendicular.
• To evaluate the success rate and safety of adductor canal catheterization.

Main Methods:

• A randomized blinded pilot study was conducted in 16 healthy volunteers.
• Catheters were placed using parallel and perpendicular techniques in alternating legs.
• Lidocaine was injected, and success was defined by loss of cold sensation; catheter position was assessed by ultrasound.

Main Results:

• The perpendicular technique achieved 100% primary placement success, compared to 94% for the parallel technique.
• Catheter displacement occurred in 3 instances with the perpendicular approach and 1 with the parallel approach on day 2.
• Most displaced catheters were repositionable, and transient sensory deficits were reported in three volunteers.

Conclusions:

• Suture-method catheters can be successfully placed in the adductor canal using both parallel and perpendicular techniques.
• The perpendicular approach demonstrated a higher initial success rate.
• Further research may optimize techniques to minimize catheter displacement.