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Abstract
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Background and Aims Femoral, Obturator and Lateral femoral cutaneous nerves are situated in different anatomical planes. These nerves are approached with different punctures under ultrasound guidance. We looked at a single puncture approach to all three nerves and if injected dye in all three planes would adequately stain these nerves.
Methods In 2 cadavers donated through body donation programme for science studies, 0.1% methylene blue dye was injected in various anatomic planes. Sciatic nerve was located with the probe positioned in the anteromedial thigh (axial plane), with visualization of the femoral artery. These two structures usually align in one plane. In an out of plane approach, needle is inserted lateral to femoral artery and 10ml dye is injected. Needle tip is advanced towards the sciatic nerve and 20ml is injected. The probe in the axial plane is shifted medial to identify the adductor planes. The needle is advanced in plane beneath the probe and the plane between the adductors are targeted with 5ml injected in each plane. One cadaver underwent cross-section and the other was dissected, to investigate the presence of dye in specific planes
Results Dissected specimen revealed dye spread in the vicinity of femoral and obturator nerves. In one sciatic the dye was in para-neural sheath and in other it was more proximal and in sub para-neural sheath. The cross-sections, however, divulged the dye in specific planes
Conclusions The single puncture ultrasound guided approach to all nerves is a possibility. All the nerves except one sciatic nerve were adequately stained in desired anatomic planes
Dissection anterior and medial thigh with the dye in femoral triangle and adductor canal; and at the anterior obturator nerve. Figure 2 MBD at the branches of the femoral nerve, in the adductor plane and at the sciatic nerve