12 results on '"Siska Bjørn"'
Search Results
2. An Iliopsoas Plane Block does not Cause Motor Blockade:a Blinded Randomized Volunteer Trial
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Siska Bjørn, Niels Dalsgaard Nielsen, Thomas Dahl Nielsen, Kjeld Søballe, Jens Børglum, Helle K. Østergaard, Merete N. Madsen, Thomas Fichtner Bendtsen, and Erik Morre Pedersen
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HIP ,Lidocaine ,Iliopsoas Muscle ,business.industry ,030208 emergency & critical care medicine ,General Medicine ,HAND-HELD DYNAMOMETER ,03 medical and health sciences ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,Femoral nerve ,Cadaver ,Anesthesia ,medicine ,Paralysis ,030212 general & internal medicine ,FEMORAL NERVE BLOCK ,medicine.symptom ,Iliopsoas ,Fascial compartment ,business ,Volunteer ,medicine.drug ,INNERVATION - Abstract
Background A femoral nerve block relieves pain after total hip arthroplasty, but its use is controversial due to motor paralysis accompanied by an increased risk of fall. Assumedly, the iliopsoas plane block (IPB) targets the hip articular branches of the femoral nerve without motor blockade. However, this has only been indicated in a cadaver study. Therefore, we designed this volunteer study. Methods Twenty healthy volunteers were randomly allocated to blinded paired active vs. sham IPB (5 mL lidocaine 18 mg/mL with epinephrine vs saline). The primary outcome was reduction of maximal force of knee extension after IPB compared to baseline. Secondary outcomes included reduction of maximal force of hip adduction, and the pattern of injectate spread assessed with magnetic resonance imaging. Results Mean (confidence interval) change of maximal force of knee extension from baseline to after IPB was -9.7 N (-22, 3.0) (P = .12) (n = 14). The injectate was consistently observed in an anatomically well-defined closed fascial compartment between the intra- and extra-pelvic components of the iliopsoas muscle anterior to the hip joint. Conclusion We observed no significant reduction of maximal force of knee extension after an IPB. The injectate was contained in a fascial compartment previously shown to contain all sensory branches from the femoral nerve to the hip joint. The clinical consequence of selective anesthesia of all sensory femoral nerve branches from the hip could be a reduced risk of fall compared to a traditional femoral nerve block. Registration of Trial: The trial was prospectively registered in EudraCT (Reference: 2018-000089-12, https://www.clinicaltrialsregister.eu/ctr-search/search?query=2018-000089-12). more...
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- 2020
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3. ESRA19-0563 The role of intermediate and medial femoral cutaneous nerve blocks in anesthesia of the anteromedial knee region
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Thomas Dahl Nielsen, Thomas Fichtner Bendtsen, and Siska Bjørn
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business.industry ,medicine.medical_treatment ,Total knee arthroplasty ,Knee region ,Medial femoral cutaneous nerve ,medicine.anatomical_structure ,Primary outcome ,Femoral triangle ,Anesthesia ,medicine ,Nerve block ,Midline incision ,business ,Reduction (orthopedic surgery) - Abstract
Background and aims Incisional and anteromedial pain is often present after total knee arthroplasty (TKA) despite a saphenous and medial vastus nerve block at midthigh level (distal femoral triangle block, FTB). We aimed to investigate whether a block of the intermediate femoral cutaneous nerve branches (IFCNB) would increase the area of anesthesia and whether this would be further improved by replacing the traditional FTB with a more proximal approach (i.e. proximal FTB) thereby in addition anesthetizing the medial femoral cutaneous nerve. Methods Forty healthy volunteers were enrolled in this randomized, double-blind trial. the standard midline incision for TKA was drawn on the skin. Volunteers were randomized (group 1–4) receiving active distal FTB on one side and active proximal FTB on the other combined with active IFCNB on one side (figures 1, 2). Primary outcome was anesthesia of the incision with proximal FTB and IFCNB versus proximal FTB. Secondary outcomes included reduction in muscle strength, and the coverage of the incision line and anteromedial aspect with distal FTB. Results Addition of IFCNB to proximal FTB significantly increased complete anesthesia of the incision line. After distal FTB and IFCNB a non-anesthetized area was present anteromedially in 90% of cases (Figure 3). After proximal and distal FTB muscle strength was significantly reduced, however, ambulation was maintained. Addition of IFCNB did not cause further reduction. Conclusions Proximal FTB combined with IFCNB had a high success rate of anesthetizing the incision line and anteromedial aspect of the knee. In contrast, distal FTB and IFCNB did not produce relevant anesthesia. more...
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- 2019
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4. Anesthesia of the anterior femoral cutaneous nerves for total knee arthroplasty incision: randomized volunteer trial
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Romed Hoermann, Thomas Dahl Nielsen, Siska Bjørn, Thomas Fichtner Bendtsen, and Bernhard Moriggl
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Sartorius muscle ,business.industry ,General Medicine ,Placebo ,03 medical and health sciences ,Dissection ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,030202 anesthesiology ,Femoral triangle ,Cadaver ,Anesthesia ,lower extremity ,Medicine ,business ,postoperative pain ,regional anesthesia ,Volunteer ,Surgical incision ,030217 neurology & neurosurgery ,Subcutaneous tissue - Abstract
Background and objectives For pain relief after total knee arthroplasty (TKA), an injection at the midthigh level may produce analgesia inferior to that of a femoral nerve block as the anterior femoral cutaneous nerves (intermediate femoral cutaneous nerve (IFCN) and medial femoral cutaneous nerve (MFCN)) are not anesthetized. The IFCN can be selectively anesthetized in the subcutaneous tissue above the sartorius muscle and the MFCN by an injection in the proximal part of the femoral triangle (FT). The primary aim was to investigate the area of cutaneous anesthesia in relation to the surgical incision for TKA and anteromedial knee area after intermediate femoral cutaneous nerve blockade (IFCNB) in combination with an injection in the proximal or distal part of the FT (proximal vs distal femoral triangle block (FTB)). Methods The study was carried out as two separate investigations: first, dissection of nine cadaver sides to verify a technique for IFCNB; second, a volunteer study with 40 healthy volunteers. The surgical midline incision for TKA was drawn bilaterally. All volunteers received an active distal FTB combined with a placebo proximal FTB on one side and vice versa on the other side. All volunteers were randomized to an active IFCNB on one side and placebo IFCNB on the contralateral side. Results Identification of IFCN was successful in all cadaver sides. Fifteen out of 20 volunteers had complete anesthesia of the incision line after IFCNB combined with proximal FTB, which was significantly higher compared with proximal FTB alone and with distal FTB+IFCNB. A gap at the anteromedial knee area was present in 2/20 volunteers with proximal FTB compared with 17/20 with distal FTB when all volunteers had active IFCNB. Conclusion Ultrasound-guided blockade of the IFCN and MFCN anesthetize the surgical midline incision and the anteromedial area of the knee relevant for TKA. In contrast, an injection at the midthigh level produces insufficient cutaneous anesthesia not covering the areas of interest. Trial registration number EudraCT: 2018-004986-15. more...
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- 2019
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5. Pain relief after total knee arthroplasty with vastus lateralis nerve block
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Thomas Fichtner Bendtsen, Thomas Dahl Nielsen, and Siska Bjørn
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musculoskeletal diseases ,medicine.medical_specialty ,business.industry ,Postoperative pain ,medicine.medical_treatment ,Pain relief ,Total knee arthroplasty ,General Medicine ,musculoskeletal system ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,030202 anesthesiology ,Femoral triangle ,medicine ,Nerve block ,Severe pain ,business ,human activities ,030217 neurology & neurosurgery - Abstract
To the Editor, We applied an ultrasound-guided vastus lateralis nerve block[1][1] in a patient with severe pain at the lateral aspect of the knee following primary total knee arthroplasty (TKA). Preoperatively at 07:30 hours, the patient had a proximal femoral triangle block anterolateral to the more...
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- 2019
6. Effect of Perineural Dexamethasone on the Duration of Single Injection Saphenous Nerve Block for Analgesia After Major Ankle Surgery
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Frank Linde, Rasmus W. Hauritz, Jens Børglum, Thomas Fichtner Bendtsen, Kristian K. Nielsen, and Siska Bjørn
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Male ,Pain Threshold ,medicine.medical_specialty ,Time Factors ,Denmark ,Dexamethasone ,Injections ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,030202 anesthesiology ,law ,Interquartile range ,medicine ,Humans ,Orthopedic Procedures ,Prospective Studies ,Anesthetics, Local ,Prospective cohort study ,Glucocorticoids ,Aged ,Pain Measurement ,Bupivacaine ,Pain, Postoperative ,business.industry ,Nerve Block ,General Medicine ,Middle Aged ,Surgery ,Analgesics, Opioid ,Saphenous nerve ,Treatment Outcome ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Opioid ,Anesthesia ,Female ,Ankle ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
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. All patients received a continuous sciatic catheter and were randomized to receive a single-injection saphenous nerve block with 10 mL of 0.5% bupivacaine with 1:200,000 epinephrine with addition of 1 mL of saline or 1 mL of 0.4% (ie, 4 mg) dexamethasone. The primary outcome was duration of saphenous nerve block estimated as the time until the first opioid request. Secondary outcomes were opioid consumption and pain.RESULTS: The mean (SD) duration of the saphenous nerve block until first opioid request was 29.4 (8.4) hours in the dexamethasone group and 23.2 (10.3) hours in the control group (P = 0.048). The median opioid consumption [interquartile range] during the first 24 hours was 0 mg [0-0] versus 1.5 mg [0-14.2] in the dexamethasone and control groups, respectively. Nonparametric comparison of opioid consumption from 0 to 24 hours was statistically significant. The opioid consumption was similar in the two groups in the time interval 24 to 48 postoperative hours.CONCLUSION: Perineural dexamethasone as an adjuvant for the single-injection subsartorial saphenous nerve block can prolong analgesia and reduce opioid-requiring pain after major ankle surgery. more...
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- 2017
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7. The Importance of the Saphenous Nerve Block for Analgesia Following Major Ankle Surgery:A Randomized, Controlled, Double-Blind Study
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Rasmus W. Hauritz, Siska Bjørn, Thomas Fichtner Bendtsen, Jens Børglum, Wan Yi Wong, Kristian K. Nielsen, and Jorgen Baas
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Male ,medicine.medical_specialty ,Nerve Block/methods ,medicine.medical_treatment ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,030202 anesthesiology ,medicine ,Pain, Postoperative/diagnostic imaging ,Humans ,Clinical significance ,Prospective Studies ,Anesthetics, Local ,Prospective cohort study ,Saline ,Pain Measurement ,Aged ,Bupivacaine ,Pain, Postoperative ,business.industry ,Anesthetics, Local/administration & dosage ,Nerve Block ,General Medicine ,Middle Aged ,Surgery ,Clinical trial ,Saphenous nerve ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Nerve block ,Ankle/diagnostic imaging ,Female ,Analgesia/methods ,Analgesia ,Ankle ,Bupivacaine/administration & dosage ,business ,Pain Measurement/drug effects ,030217 neurology & neurosurgery ,medicine.drug - Abstract
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. Patients were randomized to single-injection saphenous nerve block with 10 mL 0.5% bupivacaine with 1:200,000 epinephrine or 10 mL saline (Fig. 1). Primary outcome was the proportion of patients reporting significant clinical pain, defined as a score greater than 3 on the numerical rating scale. Secondary outcomes were maximal pain and analgesia of the cutaneous territory of the infrapatellar branch of the saphenous nerve.RESULTS: Eight of 9 patients in the placebo group reported significant clinical pain versus 1 of 9 patients in the bupivacaine-epinephrine group (P = 0.003). Maximal pain was significantly lower in the active compared with the placebo group (median, 0 [0-0] vs 5 [4-6]; P = 0.001). Breakthrough pain from the saphenous territory began within 30 minutes after surgery in all cases. Sensory testing of the cutaneous territory of the infrapatellar branch of the saphenous nerve showed correlation between pain reported in the anteromedial ankle region and the intensity of cutaneous sensory block in the anteromedial knee region.CONCLUSIONS: The saphenous nerve is an important contributor to postoperative pain after major ankle surgery, with significant clinical pain appearing within 30 minutes after surgery.CLINICAL TRIALS REGISTRATION: This study has been registered at ClinicalTrials.gov, identifier NCT02697955. more...
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- 2018
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8. The effect of perineural dexamethasone on duration of sciatic nerve blockade:a randomized, double-blind study
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C. W. Henriksen, Jens Børglum, Rasmus W. Hauritz, Siska Bjørn, Thomas Fichtner Bendtsen, and Kjartan Eskjaer Hannig
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Adult ,Male ,Time Factors ,medicine.medical_treatment ,Dexamethasone ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,030202 anesthesiology ,Medicine ,Humans ,Prospective Studies ,Saline ,Aged ,Pain, Postoperative ,business.industry ,Foot ,Dexamethasone/pharmacology ,Foot and ankle surgery ,Nerve Block ,Pain, Postoperative/prevention & control ,General Medicine ,Middle Aged ,Sciatic Nerve ,Blockade ,Saphenous nerve ,Anesthesiology and Pain Medicine ,Opioid ,Anesthesia ,Foot/surgery ,Nerve block ,Ankle/surgery ,Female ,Sciatic nerve ,Ankle ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
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. systemic absorption of the dexamethasone is still not fully elucidated. We aimed to investigate the postoperative duration of sensorimotor blockade with either dexamethasone or saline added to bupivacaine-epinephrine. Methods: Fifty six patients scheduled for surgery were randomly assigned to a popliteal sciatic nerve block of 18 ml 0.5% bupivacaine-epinephrine with either 2 ml of 0.4% dexamethasone or 2 ml 0.9% normal saline added. Sensory and motor functions were tested every 30 min until normalized nerve functions. Primary outcome was time until complete return of sensorimotor functions. Results: Mean (SD) time until return of normal sensory and motor functions was 26 (6) vs. 16 (4) hours, P more...
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- 2018
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9. The analgesic effect of a popliteal plexus blockade after total knee arthroplasty: A feasibility study
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Niels Dalsgaard Nielsen, C. Holm, Charlotte Runge, M. Vase, Jan Mick Jensen, Siska Bjørn, and Thomas Fichtner Bendtsen
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musculoskeletal diseases ,Plexus ,business.industry ,Popliteal fossa ,Popliteal plexus block ,General Medicine ,Femoral triangle block ,03 medical and health sciences ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,030202 anesthesiology ,Femoral triangle ,Interquartile range ,Total knee arthroplasty ,Anesthesia ,Medicine ,Obturator nerve ,Sciatic nerve ,Ankle ,Analgesia ,business ,Tibial nerve ,030217 neurology & neurosurgery - Abstract
Introduction: An obturator nerve block (ONB) and a femoral triangle block (FTB) provide effective analgesia after total knee arthroplasty (TKA) without impeding the ambulation, although the ONB produces motor blockade of the hip adductor muscles. The popliteal plexus (PP) in the popliteal fossa is formed by contribution from the tibial nerve and the posterior obturator nerve, innervating intraarticular genicular structures and the posterior capsule of the knee. We hypothesised that a popliteal plexus block (PPB) as a supplement to an FTB would reduce pain after TKA without anaesthetising motor branches from the sciatic nerve in the popliteal fossa. Aim: To assess the analgesic effect of adding a PPB to an FTB in 10 subjects with significant pain after TKA. Methods: All subjects underwent unilateral TKA with spinal anaesthesia and received an FTB. The cutaneous sensation and the postoperative pain were assessed. The primary outcome was the proportion of subjects with pain above numeric rating scale (NRS) 3 followed by a reduction to NRS 3 or below after conducting a PPB. Results: Ten subjects with a median pain of NRS 5.5 (interquartile range [IQR] 4-8) after unilateral TKA received a PPB. All 10 subjects experienced a reduction in pain to NRS 3 or below (NRS 1.5 [IQR 0-3]) within a mean time of 8.5 (95% CI 6.8-10.2) minutes. Three subjects were completely pain free after the PPB. The ankle muscle strength was not affected. Conclusions: The PPB provided effective pain relief without affecting the ankle muscle strength in all 10 subjects with significant pain after TKA and an FTB. more...
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- 2018
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10. DOES THE SAPHENOUS NERVE PLAY AN IMPORTANT ROLE AFTER MAJOR ANKLE SURGERY?
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Siska, Bjørn, primary and Fichtner Bendtsen, Thomas, primary
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- 2018
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11. Real-Time Ultrasound/MRI Fusion for Suprasacral Parallel Shift Approach to Lumbosacral Plexus Blockade and Analysis of Injectate Spread: An Exploratory Randomized Controlled Trial
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Morten Daugaard, Erik Morre Pedersen, Kjeld Søballe, Jennie Maria Christin Strid, Sinan Naseer Hussain Al-Karradi, Siska Bjørn, Mathias Alrø Fichtner Bendtsen, Thomas Fichtner Bendtsen, Mette Dam, Martin Sejr Hansen, Katrine Danker Linnet, and Jens Børglum more...
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Epidural Space ,Male ,medicine.medical_treatment ,Lumbosacral Plexus ,Lumbosacral trunk ,PSOAS COMPARTMENT BLOCK ,lcsh:Medicine ,0302 clinical medicine ,030202 anesthesiology ,MAGNETIC-RESONANCE ,Anesthetics, Local ,Brachial plexus block ,medicine.diagnostic_test ,Ultrasound ,Nerve Block ,General Medicine ,Magnetic Resonance Imaging ,Lumbosacral plexus ,medicine.anatomical_structure ,Female ,Radiology ,Adult ,medicine.medical_specialty ,LUMBAR ,Article Subject ,Epinephrine ,IMAGES ,General Biochemistry, Genetics and Molecular Biology ,medicine.nerve ,03 medical and health sciences ,AGE ,medicine ,Humans ,VOLUNTEERS ,Ultrasonography, Interventional ,ANESTHESIA ,General Immunology and Microbiology ,business.industry ,GUIDANCE ,lcsh:R ,Lidocaine ,Magnetic resonance imaging ,HIP FRACTURE ,Brachial Plexus Block ,Crossover study ,Epidural space ,Clinical Study ,Nerve block ,business ,COMORBIDITY ,030217 neurology & neurosurgery - Abstract
Fused real-time ultrasound and magnetic resonance imaging (MRI) may be used to improve the accuracy of advanced image guided procedures. However, its use in regional anesthesia is practically nonexistent. In this randomized controlled crossover trial, we aim to explore effectiveness, procedure-related outcomes, injectate spread analyzed by MRI, and safety of ultrasound/MRI fusion versus ultrasound guided Suprasacral Parallel Shift (SSPS) technique for lumbosacral plexus blockade. Twenty-six healthy subjects aged 21–36 years received two SSPS blocks (20 mL 2% lidocaine-epinephrine [1 : 200,000] added 1 mL diluted contrast) guided by ultrasound/MRI fusion versus ultrasound. Number (proportion) of subjects with motor blockade of the femoral and obturator nerves and the lumbosacral trunk was equal (ultrasound/MRI, 23/26 [88%]; ultrasound, 23/26 [88%];p=1.00). Median (interquartile range) preparation and procedure times (s) were longer for the ultrasound/MRI fusion guided technique (686 [552–1023] versus 196 [167–228],p<0.001and 333 [254–439] versus 216 [176–294],p=0.001). Both techniques produced perineural spread and corresponding sensory analgesia from L2 to S1. Epidural spread and lidocaine pharmacokinetics were similar. Different compartmentalized patterns of injectate spread were observed. Ultrasound/MRI fusion guided SSPS was equally effective and safe but required prolonged time, compared to ultrasound guided SSPS. This trial is registered with EudraCT (2013-004013-41) and ClinicalTrials.gov (NCT02593370). more...
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- 2017
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12. Defining the Location of the Adductor Canal Using Ultrasound
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Siska Bjørn, Wan Yi Wong, Jens Børglum, Jennie Maria Christin Strid, and Thomas Fichtner Bendtsen
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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. more...
- Published
- 2016
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