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PROXIMAL SPREAD OF LOCAL ANAESTHETIC IN ADDUCTOR CANAL, MEASURED WITH ULTRASOUND.
Author(s):
Wilson, A.*
Affiliations:
Leeds Teaching Hospitals NHS Trust, Anaesthetic Department, Leeds, United Kingdom
ESRA Academy. Plotnikova O. Sep 13, 2017; 190885
Topic: REGIONAL ANAESTHESIA (RA) IN SPECIFIC SUBPOPULATIONS
Dr. Olga Plotnikova
Dr. Olga Plotnikova

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Abstract
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Background and Aims:

Adductor canal block (ACB) has recently gained popularity for ambulatory knee surgery by blocking the saphenous nerve and other genicular branches without a motor block.

To this aim many practitioners only use 10 mls to minimise spread outside of the true ACB. The extend of spread is however to date undocumented. 

Methods:

We audited patients who required an ACB and measured an immediate proximal spread of Local Anaesthetic (LA) in the canal using an ultrasound. 

Adductor canal was scanned prior to the procedure. We followed SFA (Superficial Femoral Vein)down until the lateral boarder of Sartorius muscle no longer covered the artery (the end of the adductor canal) and injected LA 1 cm above from this point.

Proximal spread was measured immediately following injection of 10 mls of LA by two independent assessors.

15 patients were included in the audit

Results:

The proximal spread of LA in adductor canal ranged between 3.5 cm-17 cm.

We did not observe any LA in femoral triangle following injection of 10 mls.

It appears in this small audit that there is no correlation between spread height, gender and BMI .

 

Conclusions:

In our audit 10 mls of LA would have an unpredictable spread within adductor canal proximally and distally, but never reach a femoral triangle.

 

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