Evaluation by Ultrasound Imaging of Local Anesthetic Spread to the Popliteal Fossa During an Adductor Canal Block
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Knee Injuries
- Sponsor
- Assistance Publique - Hôpitaux de Paris
- Enrollment
- 30
- Locations
- 1
- Primary Endpoint
- Frequency of local anesthetic's spread
- Status
- Terminated
- Last Updated
- 5 months ago
Overview
Brief Summary
Adductor canal block is an effective analgesic technique for major knee surgery. However, the saphenous nerve block is not sufficient to explain this block's efficiency. It has been shown that adductor canal block can spread to the tibial and fibular nerves through the adductor hiatus. However this diffusion's frequency has never been measured. The main objective of this study is to assess the frequency of the spread of the adductor canal block to the fibular and tibial nerves assessed by ultrasound observation at the popliteal fossa.
Detailed Description
Adductor canal block is an effective analgesic technique for major knee surgery. The PROSPECT group recommends this block in first intention for locoregional anesthesia in total knee arthroplasty. It has been shown to not be inferior to femoral nerve block in this indication. The adductor canal block targets the saphenous nerve and, through its spread in the adductor canal, the posterior branch of obturator nerve and the vastus medialis nerve. However these nerves can't fully explain this block's efficiency. It has been shown that local anesthetic can spread in the adductor canal to the tibial and fibular nerves through the adductor hiatus. However, this spread is inconstant, and no study has evaluated the frequency of this spread yet. The main objective of this study is to assess the diffusion's frequency of adductor canal block to fibular and tibial nerves through ultrasound observation at the popliteal fossa.
Investigators
Eligibility Criteria
Inclusion Criteria
- •patients scheduled for elective knee surgery under general anesthesia
- •in center of Ambroise Paré hospital
- •receiving an adductor canal block
Exclusion Criteria
- •patients cognitively impaired
- •patients suffering from peripheral neuropathy at the lower limb
- •patients receiving an IPACK block or surgical knee infiltration to complete the adductor canal block analgesia
- •patients who refused to take part in this study
- •pregnant or breastfeeding patients
- •patients under guardianship
- •imprisoned patients
- •patients without any medical insurance
Outcomes
Primary Outcomes
Frequency of local anesthetic's spread
Time Frame: at baseline
The primary outcome is the frequency of local anesthetic's spread to tibial and fibular nerve during an adductor canal block, assessed by ultrasound imaging at the popliteal fossa level. The ultrasound images will be recorded and then assessed by two independent anesthesiologists.
Secondary Outcomes
- Frequency of altered sensibility(at one and four hours)
- Correlation between local anesthetic spread and clinical alteration(at baseline, hour 1 and hour 4th)