1. Defining the Location of the Adductor Canal Using Ultrasound
- Author
-
Siska Bjørn, Wan Yi Wong, Jens Børglum, Jennie Maria Christin Strid, and Thomas Fichtner Bendtsen
- Subjects
musculoskeletal diseases ,Male ,animal structures ,Nerve Block/methods ,Adductor canal ,medicine.medical_treatment ,Anterior superior iliac spine ,Muscle, Skeletal/anatomy & histology ,Thigh ,Regional Anesthesia and Acute Pain: Brief Technical Reports ,TOTAL KNEE ARTHROPLASTY ,ANALGESIA ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,stomatognathic system ,SAPHENOUS NERVE BLOCK ,030202 anesthesiology ,Predictive Value of Tests ,STRENGTH ,Medicine ,Humans ,Ligaments/anatomy & histology ,Muscle, Skeletal ,INNERVATION ,Ultrasonography ,Sartorius muscle ,Ligaments ,business.industry ,digestive, oral, and skin physiology ,PAIN ,Nerve Block ,General Medicine ,Anatomy ,MUSCLE ,musculoskeletal system ,ANATOMY ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Femoral triangle ,Adductor longus muscle ,Nerve block ,Adductor hiatus ,Female ,Anatomic Landmarks ,business ,030217 neurology & neurosurgery - Abstract
Background and Objectives: The precise location of the adductor canal remains controversial among anesthesiologists. In numerous studies of the analgesic effect of the so-called adductor canal block for total knee arthroplasty, the needle insertion point has been the midpoint of the thigh, determined as the midpoint between the anterior superior iliac spine and base of patella. "Adductor canal block"may be a misnomer for an approach that is actually an injection into the femoral triangle, a "femoral triangle block." This block probably has a different analgesic effect compared with an injection into the adductor canal.We sought to determine the exact location of the adductor canal using ultrasound and relate it to the midpoint of the thigh. Methods: Twenty-two volunteers were examined using ultrasound. The proximal end of the adductor canalwas identified where the medial border of the sartorius muscle intersects the medial border of the adductor longus muscle. The distal end of the adductor canal is the adductor hiatus, which was also visualized ultrasonographically. Results: The mean distance from the anterior superior iliac spine to the midpoint of the thigh was 22.9 cm (range, 20.3-24.9 cm). The mean distance from the anterior superior iliac spine to the proximal end of the adductor canal was 27.4 cm (range, 24.0-31.4 cm). Consequently, the mean distance from the midpoint of the thigh to the proximal end of the adductor canal was 4.6 cm (range, 2.3-7.0 cm). Conclusions: In all volunteers, the midpoint of the thigh was proximal to the beginning of the adductor canal, suggesting that an injection performed at this level is in fact a femoral triangle block.
- Published
- 2016
- Full Text
- View/download PDF