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Abstract
Application for ESRA Abstract Prizes: I apply as an Anesthesiologist (Aged 35 years old or less)
Background and Aims Genicular nerve block (GNB) is an increasingly popular technique for pain relief after knee surgery. However, the reproducibility in terms of local anesthetic diffusion in each nerve of the block remains unclear. The objective of present study was to investigate the diffusion of contrast agent following GNB in cadaveric knees and assess the reproducibility of the infiltration volume and its distribution.
Methods Ten cadaveric knees undergoing 4 ml GNB were included, targeting the superior medial (SM), superior lateral (SL), inferior medial (IM), inferior lateral (IL), and recurrent tibial (RT) genicular nerves. Helical CT scans were performed to assess contrast distribution. Image processing, including segmentation and surface reconstruction, was performed using Amira software. Quantitative analysis was carried out to evaluate the diffusion of the infiltrated volume in each genicular nerve.
Results The mean volumes (± SD) of the contrast in SM, SL, IM, IL, and RT GNB were 15.2 ± 8.6 ml, 12.2 ± 7.9 ml, 15.0 ± 6.6 ml, 11.9 ± 9.2 ml, and 21.6 ±
15.0 ml, respectively. The mean diffusion in the three axes showed variations and coefficients of variation were calculated for each nerve to assess reproducibility.
Contrast distribution within the different knee compartments after GNB
Conclusions This study demonstrates variability in the volume and diffusion of contrast agent following GNB in cadaveric knees. Certain nerves, such as IM, exhibited greater variability compared to others. More research is needed to determine the optimal volume required to cover a relevant bony area for each nerve and to assess whether this diffusion is accompanied by clinically significant outcomes.