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A Paravenous Approach for the Saphenous Nerve Block
  1. Jean-Claude J. De Mey, M.D.,
  2. Ludwig J. Deruyck, M.D.,
  3. Guy Cammu, M.D.,
  4. Luc E. De Baerdemaeker, M.D. and
  5. Eric P. Mortier, M.D.
  1. From St Lucas Hospital (J.-C.J.D.M., L.J.D.), Ghent, Belgium; and Department of Anesthesia, Ghent University Hospital (J.-C.J.D.M., G.C., L.E.DeB., E.P.M.), Ghent, Belgium.
  1. Reprint requests: Jean-Claude J. De Mey, M.D., Department of Anesthesia, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium. E-mail: jeanclaude.demey{at}rug.ac.be

Abstract

Background and Objectives This study assesses a paravenous approach for saphenous nerve block at approximately the level of the tibial tuberosity, and compares it with the conventional technique of blind subcutaneous infiltration between the tibial tuberosity and the gastrocnemius muscle.

Methods In dissections of 5 cadavers, the saphenous nerve was found very close to the saphenous vein bilaterally. Subsequently, in 20 volunteers, a bilateral saphenous nerve block was performed with 5 mL mepivacaine on each side. Randomly assigned, the block was performed by blind subcutaneous injection using a 23-gauge needle of 2.5 cm on one side and by a paravenous subcutaneous approach on the other.

Results The paravenous approach produced a saphenous nerve block in all 20 volunteers whereas the blind subcutaneous approach was successful in only 6 (33%) (P < .05). Seven volunteers had a painless minor hematoma at the paravenous site and 2 had a hematoma at the classical site.

Conclusion The saphenous nerve can be blocked effectively by a paravenous approach using only 5 mL of local anesthetic solution. This approach is advantageous because of its easily identifiable landmark.

  • Anesthetic technique
  • Regional
  • Saphenous block
  • Saphenous vein

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Footnotes

  • Supported financially by the Department of Anesthesia, Ghent University Hospital, Ghent, Belgium.

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