Compartments and nerve blocks in the leg bellow knee

Czech version

Authors: D. Nalos ¹; Ľ. Beňo ¹; O. Naňka ²; J. Hlásny ³; I. Grgač ⁴
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, Univerzita Karlova, 1. lékařská fakulta, Praha ²; II. klinika anestéziológie a intenzívnej medicíny SZU, Fakultná nemocnica s poliklinikou F. D. Roosevelta, Banská Bystrica ³; Anatomický ústav LF UK, Bratislava ⁴
Published in: Anest. intenziv. Med., 32, 2021, č. 3, s. 156-163
Category: Review Article

Overview

The article describes the anatomical relationships of peripheral nerves with theirs surrounding structures in the leg bellow knee joint. Attention is focused on the connective tissues that accompany macroscopically visible nerves. Ultrasound imaging allows to identify superficial, deep fascias and fascial compartments of the leg. Visualization of superficial and deep structures enables the performance of nerve blockages at sites outside of usual locations. Ultrasound assistance provides us with a wider range of peripheral nerve block options on the lower limb and allows to individually adjust the range of the blocks to patient’s requirement.

Keywords:

Nerve block – lower limb – ultrasound

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: 1153–1166.

3. Andersen HL. Andersen SL, Tranum‑Jensen J. Injection inside the paraneural sheath of the sciatic nerve: direct comparison among ultrasound imaging, macroscopic anatomy, and histologic analysis. Reg Anesth Pain Med. 2012; 37: 410–414.

4. Chang KV, Mezian K, Naňka O, Wu WT, Lou YM, Wang JCh, et al. Ultrasound Imaging for the Cutaneous Nerves of the Extremities and Relevant Entrapment Syndromes: From Anatomy to Clinical Implications. J.Clin Med. 2018; 21: 457. doi: 10.3390/jcm 7110457.

5. Schurman DJ. Ankle block anesthesia for foot surgery. Anesthesiology 1976; 44: 348–352.

6. Grim M, Naňka O, Helekal I. Atlas anatomie člověka. Grada 2017.