Ultrasound-guided knee pericapsular plexus block:A cadaver and a volunteer study
Objective To investigate into the feasibility of ultrasound-guided knee pericapsular plexus block and to test its block area.Methods The study was designed in two parts involving cadavers and volunteers.First,the four nerves constituing the knee pericapsular plexus,including the anterior branch of the lateral fem-oral cutaneous nerve,intermediate femoral cutaneous nerve,inferior patellar branch of the saphenous nerve,and anterior branch of the medial femoral cutaneous nerve,were identified and followed on the lower limbs of ten cadavers under ultrasound guidance.Then a solution of 0.01%methylene blue was injected into the most optimal imaging location,followed by cadaver dissection to evaluate nerve staining.Second,ultrasound-guided knee pericapsular plexus block was performed on one lower limbs of every 25 volunteers,followed by a recording of the block area and lower limb mobilization of the affected leg.Results The cadaver study revealed that all four nerves could be clearly identified under ultrasound.The intermediate femoral cutaneous nerve,inferior patellar branch of the saphenous nerve,and anterior branch of the medial femoral cutaneous nerve pierced or wound around the sartorius muscle and then ran superficial to it followed by being superficial to the junction of the sartorius muscle and vastus medialis muscle.The lateral femoral cutaneous nerve primar-ily ran superficial to the rectus femoris muscle in the anterior thigh.After dye injection,the knee pericapsular plexus of all cadavers were stained,while the femoral and saphenous nerves remained unstained.The volun-teer study showed that the block area after knee pericapsular plexus block extended from the tibial tuberosity to the upper end of the thigh,medially to the inner edge of the medial condyle and laterally to the outer edge of the lateral condyle,covering the entire anterior knee area.The average blocking duration was 14.72 h,and no volunteers experienced motor weakness in the lower limbs.Conclusion Ultrasound-guided knee pericapsu-lar plexus block is a feasible nerve block technique with a block area covering the entire anterior knee without motor weakness.
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