Applied anatomy of saphenous nerve block near to inferior foramen of adductor canal

doi:10.13418/j.issn.1001-165x.2020.01.003

Chinese Journal of Clinical Anatomy ›› 2020, Vol. 38 ›› Issue (1) : 10-13. DOI: 10.13418/j.issn.1001-165x.2020.01.003

LI Xue-qian, LU Li-rong, LI Hong-peng, SUN Yun, ZHANG Hai-dong, ZHAO Zhen-mei

Author information +

History +

Abstract

Objective　To explore the details of anatomy and surface localization of saphenous nerve near to inferior foramen of adductor canal.　Methods　Twenty sides of lower limb from 12 cadaver specimen were dissected to measure the key structures adjacent to the adductor canal.　Results　Saphenous nerve, femoral artery and femoral vein located in the anteromedial, medial and posterior part of adductor canal, respectively. At the site of the inferior foramen of adductor canal, the descending genicular artery, vein and saphenous nerve penetrated through adductor tendon plate and appeared in adductor canal, which were accompanied by the great saphenous vein. Saphenous nerve passed through deep fascia between sartorius tendon and gracilis tendon on the medial surface of knee, and descended to the medial surface of leg and foot. The distances from inferior foramen of adductor canal to superior border of patella, to medial margin of the patella, and to the medial surface of thigh skin were (5.85±0.15) cm, (2.72±0.60) cm and (4.08±0.66) cm, respectively. Conclusions　Surface localization point of saphenous nerve block should be limited to a specific area, which is about 5.85 cm upper to the superior border of patella, 2.72 cm internal to medial margin of the patella, and 4.08 cm deep to the medial surface of thigh. For saphenous nerve blocking, femoral artery could be regarded as a localization mark above inferior foramen of adductor canal, while, the saphenous branch of the descending genicular artery as the localization mark below inferior foramen of adductor canal.

Key words

Inferior foramen of adductor canal;　Saphenous nerve;　Descending genicular artery / Saphenous nerve block

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

LI Xue-qian, LU Li-rong, LI Hong-peng, SUN Yun, ZHANG Hai-dong, ZHAO Zhen-mei. Applied anatomy of saphenous nerve block near to inferior foramen of adductor canal[J]. Chinese Journal of Clinical Anatomy. 2020, 38(1): 10-13 https://doi.org/10.13418/j.issn.1001-165x.2020.01.003

References

[1] Vora MU, Nicholas TA , Kassel CA, et al. Adductor canal block for knee surgical procedures: review article[J]. J Clin Anesth, 2016, 35(4): 295-303.
[2] Kiasari AZ, Babaei A, Alipour A, et al. Comparison of hemodynamic changes in unilateral spinal anesthesia versus epidural anesthesia below the T10 sensory level in unilateral surgeries: a double-blind randomized clinical trial[J]. Med Arch, 2017, 71(4): 274-279.
[3] Standring S. Gray’s anatomy-the anatomical basis of clinical practice[M]. 41st ed. New York: Elsevier Churchill Livingstone, 2016: 1337, 1366.
[4] Saranteas T, Anagnostis G, Paraskeuopoulos T, et al. Anatomy and clinical implications of the ultrasound-guided subsartorial saphenous nerve block[J]. Reg Anesth Pain Med, 2011, 36(4): 399-402.
[5] 高士濂. 实用解剖图谱(下肢分册, 3版)[M]. 上海: 上海科学技术出版社, 2012: 134-135.
[6] Bendtsen TF, Moriggl B, Chan V, et al. Topography of the saphenous nerve in the femoral triangle and the adductor canal[J]. Reg Anesth Pain Med, 2015, 40(4): 391-392.
[7] Marian AA, Ranganath Y, Bayman EO, et al. A Comparison of 2 ultrasound-guided approaches to the saphenous nerve block: adductor canal versus distal transsartorial: a prospective, randomized, blinded, noninferiority trial[J]. Reg Anesth Pain Med, 2015, 40(5): 623-630.
[8] Bendtsen TF, Moriggl B, Chan V, et al. Deﬁning adductor canal block[J]. Reg Anesth Pain Med, 2014, 39(3): 253-254.
[9] Tubbs RS, Loukas M, Shoja MM, et al. Anatomy and potential clinical significance of the vastoadductor membrane[J]. Surg Radiol Anat, 2007, 29(7): 569-573.
[10]Elazab EEB. Morphological study and relations of the fascia vasto-adductoria[J]. Surg Radiol Anat, 2017, 39(10): 1085-1095.
[11]Anagnostopoulou S, Anagnostis G, Saranteas T, et al. Saphenous and infrapatellar nerves at the adductor canal: anatomy and implications in regional anesthesia[J]. Orthopedics, 2016, 39(2): 259-262.
[12]Lynch JR, Okoroha KR, Lizzio V, et al. Adductor canal block versus femoral nerve block for pain control after anterior cruciate ligament reconstruction: a prospective randomized trial[J]. Am J Sports Med, 2019, 47(2): 355-363.