#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Blocks of cutaneous nerves and fascias layout of the thigh


Authors: D. Nalos 1;  Ľ. Beňo 1;  O. Naňka 2
Authors‘ workplace: Klinika anesteziologie, perioperační a intenzivní medicíny Univerzita J. E. Purkyně v Ústí nad Labem, Masarykova nemocnice v Ústí nad Labem 1;  Anatomický ústav, 1. lékařská fakulta, Univerzita Karlova, Praha 2
Published in: Anest. intenziv. Med., 32, 2021, č. 2, s. 99-104
Category: Review Articles

Overview

The article is a continuation of a series of articles on the importance of fascial layers for regional anaesthesia. This chapter focuses on skin innervation of the thigh. Skin surface is an integral part of neuroaxial blocks as well as of the established regional anesthesia of the main peripheral nerves directed to the thigh area. The anatomical course of the skin nerves is tied to the locations of superficial and deep fascias. Fascial structures are well identifiable using ultrasound guidance, which fa cilitates the identification of skin nerves and allows their selective blockage. Blocks of the peripheral skin nerves of the thigh do not affect muscle strength and mobility. Selective peripheral blocks of the subcutaneous nerves facilitate the diagnosis of chronic pain in their supply area.

Keywords:

skin nerves – fascia – ultrasound – regional anaesthesia


Sources

1. Nalos D. Fasciální prostory dolních končetin ve vztahu k regionální anestezii. Anest intenziv Med. 2021; 32(1): 33–40.

2. Grays anatomy 29. edice Longmans, Green and CO; 1946: 1153–66 Sakura S, Hara K, Ota J, Tadenuma S. Ultrasound‑guided peripheral nerve blocks for anterior cruciate ligament reconstruction: effect of obturator nerve block during and after surgery. J Anesth 2010; 24: 411–417.

3. Akkaya T, Ozturk E, Comert A, Ates Y, Gumus H, Ozturk H, et al. Ultrasound‑guided obturator nerve block: a sonoanatomic study of a new methodologic approach. Anesth Analg 2009; 108: 1037–1041.

4. Akkaya T, Comert A, Kendir S, Acar HI, Gumus H, Tekdemir I, et al. Detailed anatomy of accessory obturator nerve blockade. Minerva Anestesiol 2008; 74: 119–122.

5. Vilhelmsen F, Nersesian M, Andersen JH, Danker JK, Broeng L, Hägi‑Pedersen D, et al. Lateral femoral cutaneous nerve block with different volumes of Ropivacaine: a randomized trial in healthy volunteers. BMC Anesthesiol. 2019; 19: 165.

6. Nielsen TD, Moriggl B, Barckman J, Kølsen‑Petersen JA, Søballe K, Børglum J, et al. The Lateral Femoral Cutaneous Nerve. Description of the sensory Territory and a Novel Ultrasound‑guided Nerve block Technique. Reg Anesth Pain Med. 2018; 43: 357–366.

7. Bjørn S, Nielsen TD, Moriggl B, Hoermann R, Fichtner B. Anesthesia of the anterior femoral cutaneous nerves for total knee arthroplasty incision: randomized volunteer trial. Reg anesth Pain Med. 2020; 45: 107–116.

8. Pivec CH, Bodner G, Mayer JA, Brugger PC, Paraszti I, Moser V, et al. Novel Demonstration of the Anterior Femoral Cutaneous Nerve using Ultrasound. Ultraschall Med 2018. doi: 10.1055/s-0043-121628.

9. Riegler G, Pivec Ch, Jengojan S, Mayer JA, Schellen Ch, Trattnig S, et al. Cutaneous nerve fields of the anteromedial lower limb - Determination with selective ultrasound‑guided nerve blockade. Clin. Anat. 2020; 1–8. https://doi.org/10.1002/ca.235829.

10. Chang K, Mezian K, Naňka O, Wu W, Lou Y, Wang J, et al. Ultrasound Imaging for the Cutaneous Nerves of the Extremities and Relevant Entrapment Syndromes: From Anatomy to Clinical Implications. Journal of Clinical Medicine 2018. doi: 103390/jcm7110457.

11. Meng S, Lieba‑Samal D, Reissig L, Gruber GM, Brugger PC, Platzgummer H, et al. High‑ resolution ultrasound of the posterior femoral cutaneous nerve: visualization and initial experience with patients. Skeletal Radiol 2015; 44: 1421–1426. doi: 10.1007/ s0 0256-015-2177-6.

Labels
Anaesthesiology, Resuscitation and Inten Intensive Care Medicine

Article was published in

Anaesthesiology and Intensive Care Medicine

Issue 2

2021 Issue 2

Most read in this issue
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#