What is an adductor canal catheter?

Background: Adductor canal (AC) catheters are being used to provide continuous postoperative analgesia after total knee arthroplasty (TKA) surgery. There are anatomical arguments that most AC catheters are being inserted into the femoral triangle (FT) compartment of the thigh rather than the AC compartment.

What runs through adductor canal?

The canal contains the subsartorial artery (superficial femoral artery), subsartorial vein (superficial femoral vein), and branches of the femoral nerve (specifically, the saphenous nerve, and the nerve to the vastus medialis).

What is adductor canal block used for?

The adductor canal block is commonly used for analgesia in patients undergoing partial or total knee replacement surgery. Unlike a femoral nerve block, strength in the quadriceps is unaffected, allowing early mobilization or discharge.

How long does adductor canal block last?

The numbness lasts an average of 16 hours. Studies from HSS show that the pain-relieving properties of a femoral nerve block last much longer – up to 3 days.

What is the local adductor canal?

The adductor canal block (ACB) is the standard of care for analgesia after Anterior Cruciate Ligament (ACL) repair. ACB is performed by injecting local anesthetic (freezing) in the subsartorial canal in the thigh which is about 7-10cm long.

How deep is the adductor canal?

The depth of insertion is typically between 1.5 and 3 cm. After negative aspiration for blood, 5 mL of local anesthetics (lidocaine or bupivacaine) and 20 to 40 mg of triamcinolone is injected. The saphenous nerve can also be located by eliciting paresthesia in the distribution of the nerve.

What goes through the adductor hiatus?

The adductor hiatus (AH) can be described as an opening in the aponeurotic distal attachment of adductor magnus muscle, which transmits the femoral artery and vein from the adductor canal in the thigh to the popliteal fossa (1).

Where does the adductor canal end?

The adductor canal (Hunter’s canal, subsartorial canal) is a narrow conical tunnel located in the thigh. It is approximately 15cm long, extending from the apex of the femoral triangle to the adductor hiatus of the adductor magnus.

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What is adductor canal block?

The adductor canal block (ACB) is an interfascial plane block performed in the thigh. It anesthetizes multiple distal branches of the femoral nerve including the saphenous nerve and branches of the mixed sensory and motor nerves to the quadricep, as well as branches of the obturator nerve.

What local anesthetic does adductor canal block?

Conclusion. The dose closest to the ED95 of lidocaine 1% needed to fill the adductor canal distally with an ACB is 20 ml, closely followed by the 15 ml dose. Thus, larger volumes are not required to ensure distal spread in the canal.

How do you give an adductor canal block?

The goal is to place the needle tip just anterior to the femoral artery, deep to the sartorius muscle, and to deposit 5–10 mL (or up to 20 mL for the adductor canal nerve block) of local anesthetic until its spread around the artery is confirmed with US visualization.

Is adductor canal block a femoral nerve block?

Femoral nerve blocks (FNB) can provide effective pain relief but result in quadriceps weakness with increased risk of falls following total knee arthroplasty (TKA). Adductor canal block (ACB) is a relatively new alternative providing pure sensory blockade with minimal effect on quadriceps strength.

Is adductor canal a peripheral nerve block?

Adductor Canal Block for Knee Surgeries: An Emerging Analgesic Technique. For years, femoral nerve block (FNB) has been considered as the main peripheral nerve block for postoperative analgesia following knee surgery.

What happens if femoral nerve is damaged?

The femoral nerve itself mainly controls the thigh muscles. It is responsible for hip bending and knee extension. The femoral nerve also receives messages from the skin when there is pressure on the thigh or inner calf. Damage to the femoral nerve can cause numbness, weakness, or paralysis of the legs.

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What are the risks of a nerve block?

Side Effects and Risks of Nerve Blocks

  • Elevated blood sugars.
  • Rash.
  • Itching.
  • Weight gain.
  • Extra energy.
  • Soreness at the site of injection.
  • Bleeding.
  • Death (in rare cases)

Where are the adductor muscles?

thigh The adductors are a group of muscles, as the name suggests, that primarily function to adduct the femur at the hip joint. Although they are all located somewhere along the medial side of the thigh, they originate in different places at the front of the pelvis.

What is the CPT code for adductor canal block?

64448 My physician has just started performing adductor canal continuous infusion pain blocks? How do I code it? Answer: The correct CPT code is 64448 (Injection, anesthetic agent; femoral nerve, continuous infusion by catheter (including catheter placement) when a catheter is placed and infusion performed.

What is the femoral triangle?

The femoral triangle is a hollow region located in the supero-medial part of the anterior thigh. It appears most prominently with hip flexion, abduction and internal rotation. It is an easily accessible area through which multiple neurovascular structures pass through.

Where does the adductor canal start?

femoral triangle The adductor canal (subsartorial, Hunter’s canal) is an aponeurotic tunnel in the middle third of the thigh, extending from the apex of the femoral triangle to the opening in the adductor magnus, the adductor hiatus.

How many nerves usually pass through the adductor canal?

Adductor Canal represented in green region. It consists of three foramina: superior, anterior and inferior. The femoral artery with its vein and the saphenous nerve enter this canal through the superior foramen.

Does femoral nerve pass through adductor hiatus?

In human anatomy, the adductor hiatus also known as hiatus magnus is a hiatus (gap) between the adductor magnus muscle and the femur that allows the passage of the femoral vessels from the anterior thigh to the posterior thigh and then the popliteal fossa. …

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Adductor hiatus
TA2 2634
FMA 58784
Anatomical terminology

Is adductor canal same as hiatus?

Anatomical Parts The adductor canal (subsartorial, Hunter’s canal) is an aponeurotic tunnel in the middle third of the thigh, extending from the apex of the femoral triangle to the opening in the adductor magnus, the adductor hiatus.

What passes through the femoral canal?

It is directed upward and is oval in form, its long diameter being directed transversely and measuring about 1.25 cm. Part of the intestine can sometimes pass through the femoral ring into the femoral canal causing a femoral hernia. …

Femoral ring
FMA 77263
Anatomical terminology

Can nerve block cause permanent numbness?

Permanent nerve damage after a peripheral nerve block is very rare. The most common type of nerve damage causes an area of numb skin which is very likely to resolve within a few weeks.

What is the adductor magnus?

The Adductor Magnus muscle is one of six muscles in the medial compartment of the thigh. Adductor Magnus is a broad triangular muscle forming a septum which divides the anterior muscles from the posterior aspect of the thigh. It is the largest muscle in the medial compartment.

What is a 3 in 1 block?

One of the most common peripheral nerve blocks. to facilitate postoperative analgesia is the 3-in-1 nerve. block, which uses a single injection to block the femoral,lateral femoral cutaneous (LFC), and obturator nerves. These 3 nerves provide the major sensation to the.