Ultrasound-Guided Sub-Sartorial Spread in Adductor Canal Block: A Case Series
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Abstract
The adductor canal block (ACB) is a commonly used regional anesthesia technique in anterior cruciate ligament (ACL) repair that provides effective postoperative analgesia while preserving motor function. The adductor canal extends from the apex of the femoral triangle to the adductor hiatus and is roofed by the sartorius muscle and vasto-adductor (V-A) fascia. The subsartorial space, situated between the sartorius and V-A fascia, contains the subsartorial plexus, which contributes to the sensory innervation of the knee.
[1] Masaracchia MM, Herrick MD, Barrington MJ, Hartmann PR, Sites BD. Adductor canal blocks: changing practice patterns and associated quality profile. Acta Anaesthesiol Scand. 2017; 61(2):224-31.
[2] Kwofie MK, Shastri UD, Gadsden JC, Sinha SK, Abrams JH, Xu D, et al. The effects of ultrasound-guided adductor canal block versus femoral nerve block on quadriceps strength and fall risk: a blinded, randomized trial of volunteers. Reg Anesth Pain Med. 2013; 38(4):321-5.
[3] Sharma S, Iorio R, Specht LM, Davies-Lepie S, Healy WL. Complications of femoral nerve block for total knee arthroplasty. Clin Orthop Relat Res. 2010; 468(1):135-40.
[4] Kapoor R, Adhikary SD, Siefring C, McQuillan PM. The saphenous nerve and its relationship to the nerve to the vastus medialis in and around the adductor canal: an anatomical study. Acta Anaesthesiol Scand. 2012; 56(3):365-7.
[5] Goffin P, Lecoq JP, Ninane V, Brichant JF, Sala-Blanch X, Gautier PE, et al. Interfascial Spread of Injectate After Adductor Canal Injection in Fresh Human Cadavers. Anesth Analg. 2016; 123(2):501-3.
[6] Elazab EE. Morphological study and relations of the fascia vasto-adductoria. Surg Radiol Anat. 2017; 39(10):1085-95.
[7] Tran J, Chan VWS, Peng PWH, Agur AMR. Evaluation of the proximal adductor canal block injectate spread: a cadaveric study. Reg Anesth Pain Med. 2019; 2019:rapm-2019-101091.
[8] Ishiguro S, Yokochi A, Yoshioka K, Asano N, Deguchi A, Iwasaki Y, et al. Technical communication: anatomy and clinical implications of ultrasound-guided selective femoral nerve block. Anesth Analg. 2012; 115(6):1467-70.
[9] Andersen HL, Andersen SL, Tranum-Jensen J. The spread of injectate during saphenous nerve block at the adductor canal: a cadaver study. Acta Anaesthesiol Scand. 2015; 59(2):238-45.
[10] Tubbs RS, Loukas M, Shoja MM, Apaydin N, Oakes WJ, Salter EG. Anatomy and potential clinical significance of the vastoadductor membrane. Surg Radiol Anat. 2007; 29(7):569-73.
[2] Kwofie MK, Shastri UD, Gadsden JC, Sinha SK, Abrams JH, Xu D, et al. The effects of ultrasound-guided adductor canal block versus femoral nerve block on quadriceps strength and fall risk: a blinded, randomized trial of volunteers. Reg Anesth Pain Med. 2013; 38(4):321-5.
[3] Sharma S, Iorio R, Specht LM, Davies-Lepie S, Healy WL. Complications of femoral nerve block for total knee arthroplasty. Clin Orthop Relat Res. 2010; 468(1):135-40.
[4] Kapoor R, Adhikary SD, Siefring C, McQuillan PM. The saphenous nerve and its relationship to the nerve to the vastus medialis in and around the adductor canal: an anatomical study. Acta Anaesthesiol Scand. 2012; 56(3):365-7.
[5] Goffin P, Lecoq JP, Ninane V, Brichant JF, Sala-Blanch X, Gautier PE, et al. Interfascial Spread of Injectate After Adductor Canal Injection in Fresh Human Cadavers. Anesth Analg. 2016; 123(2):501-3.
[6] Elazab EE. Morphological study and relations of the fascia vasto-adductoria. Surg Radiol Anat. 2017; 39(10):1085-95.
[7] Tran J, Chan VWS, Peng PWH, Agur AMR. Evaluation of the proximal adductor canal block injectate spread: a cadaveric study. Reg Anesth Pain Med. 2019; 2019:rapm-2019-101091.
[8] Ishiguro S, Yokochi A, Yoshioka K, Asano N, Deguchi A, Iwasaki Y, et al. Technical communication: anatomy and clinical implications of ultrasound-guided selective femoral nerve block. Anesth Analg. 2012; 115(6):1467-70.
[9] Andersen HL, Andersen SL, Tranum-Jensen J. The spread of injectate during saphenous nerve block at the adductor canal: a cadaver study. Acta Anaesthesiol Scand. 2015; 59(2):238-45.
[10] Tubbs RS, Loukas M, Shoja MM, Apaydin N, Oakes WJ, Salter EG. Anatomy and potential clinical significance of the vastoadductor membrane. Surg Radiol Anat. 2007; 29(7):569-73.
| Files | ||
| Issue | Article in Press |
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| Section | Case Report(s) | |
| Keywords | ||
| Adductor canal block Subsartorial space Anterior Cruciate Ligament Ultrasound guidance Postoperative analgesia. | ||
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How to Cite
1.
Shah B, Wadikar P, Bhatia J. Ultrasound-Guided Sub-Sartorial Spread in Adductor Canal Block: A Case Series. Arch Anesth & Crit Care. 2026;.
