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Transsartorial approach for saphenous nerve block

M van der Wal1, S A Lang, R W Yip

  • 1Department of Anaesthesia, Royal University Hospital, University of Saskatchewan, Saskatoon, Canada.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|June 1, 1993
PubMed
Summary

A new transsartorial approach provides a highly effective saphenous nerve block for lower leg anesthesia. This method demonstrated superior success rates and improved patient analgesia compared to traditional techniques.

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Area of Science:

  • Anesthesiology
  • Surgical Anatomy
  • Pain Management

Background:

  • Saphenous nerve block is crucial for lower leg surgical anesthesia.
  • Existing techniques often lack practical clinical effectiveness.
  • A novel approach is needed to improve saphenous nerve blockade.

Purpose of the Study:

  • To develop and evaluate a transsartorial approach for saphenous nerve conduction block.
  • To compare the efficacy of the transsartorial approach against other established methods.
  • To assess the extent of anesthesia achieved in the saphenous nerve distribution.

Main Methods:

  • Cadaveric dissection confirmed nerve staining with methylene blue.
  • A comparative study in 20 volunteers assessed three techniques: transsartorial saphenous nerve block (TSSNB), femoral paracondylar field block (FPFB), and below-knee field block (BKFB).

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  • Success rates and sensory blockade to pinprick were evaluated.

    • Main Results:

    • The transsartorial saphenous nerve block (TSSNB) achieved an 80% success rate, significantly outperforming FPFB (40%) and BKFB (65%).
    • TSSNB provided superior cutaneous analgesia in the saphenous nerve distribution (P < 0.05).
    • Complete anesthesia of the medial malleolus was achieved in 94% of successful TSSNB cases, compared to <40% for BKFB and FPFB.

    Conclusions:

    • The transsartorial approach is a highly effective method for saphenous nerve blockade.
    • This technique offers superior clinical utility and patient analgesia compared to FPFB and BKFB.
    • The transsartorial approach is recommended for improved saphenous nerve anesthesia in clinical practice.