Efficacy and safety of ultrasound-guided saphenous nerve block in patients with chronic knee pain

  • Mario Andrés Arcila Lotero Anesthesiologist, Master in Epidemiology; CES University, Professor of Anesthesia and Pain, CES University, Colombian Pain Institute, Medellin, Colombia
  • Roberto Rivera Díaz Anesthesiologist, Pain and Intervention Sub-specialist, Professor of Anesthesia and Pain, CES University, Colombian Pain Institute, Medellín, Colombia
  • María Adelaida Mejía Aguilar Physician, Colombian pain Institute, Master in Epidemiology CES University, Medellm, Colombia
  • Santiago Jaramillo Jaramillo Third Year Resident of Anesthesiology, CES University, Medellin, Colombia
Keywords: Nerve block, Ultrasonography, Chronic pain, Analgesia, Fibromyalgia

Abstract

Introduction: Knee osteoarthritis is a common cause for consultation around the world. Many patients with mild symptoms respond to conservative treatment, while others require interventional therapy including peripheral nerve blocks.

Objective: To establish the clinical efficacy and safety of interventional management with ultrasound-guided saphenous nerve block in patients with chronic keen pain.

Materials and methods: Descriptive, retrospective trial in chronic keen pain patients who underwent ultrasound-guided interventional therapy at the pain clinic in the country, between September 2011 and June 2012, to determine the clinical efficacy and safety of the procedure. Data were obtained from all patients prior to the procedure, and then at two days, one month and three months later. The pain intensity was measured using the visual analog scale.

Results: 25 saphenous nerve blocks were performed. 68% of the patients experienced pain relief within two days. 56% and 40% exhibited relief one and three months after the procedure, respectively, with a statistically significant difference (p < 0.0001) between the baseline visual analog scale and the follow-up evaluation. Patients with a history of fibromyalgia, neuropathic characteristics and previous knee surgery exhibited variable analgesic responses to the procedure.

Conclusions: Interventionist chronic knee pain management with ultrasound-guided saphenous nerve block was an effective and safe approach for these patients.

References

Ikeuchi M, Ushida T, Izumi M, Tani T. Percutaneous radiofrequency treatment for refractory anteromedial pain of osteoarthritic knees. Pain Med. 2011;12:546-51.

Mallen CD, Peat G, Porcheret M. Chronic knee pain. BMJ. 2007;335:303.

Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: A review of community burden and current use of primary health care. Ann Rheum Dis. 2001;60:91-7.

Akkaya T, Ersan O, Ozkan D, Sahiner Y, Akin M, Gümüs H. Saphenous nerve block is an effective regional technique for post-menisectomy pain. Knee Surg Sports Traumatol Arthrosc. 2008;16:855-8.

Partownavid P. Ultrasound-guided peripheral nerve block. Am J Ther. 2009;16:304-12.

Koscielniak-Nielsen ZJ. Ultrasound-guided peripheral nerve blocks: What are the benefits? Acta Anaesthesiol Scand. 2008;52:727-37.

Walker KJ, McGrattan K, Aas-Eng K, Smith AF. Ultrasound guidance for peripheral nerve blockade. The Cochrane Library. 2011;3:1-64.

Marhofer P, Willschke H, Kettner S. Current concepts and future trends in ultrasound-guided regional anesthesia. Curr Opin Anaesthesiol. 2010;23:632-6.

Murray JM, Derbyshire S, Shields MO. Lower limb blocks. Anaesthesia. 2010;65 Suppl. 1:57-66.

Horn JL, Pitsch T, Salinas F, Benninger B. Anatomic basis to the ultrasound-guided approach for saphenous nerve blockade. Reg Anesth Pain Med. 2009;34:486-9.

Saranteas T, Anagnostis G, Paraskeuopoulos T, Koulalis D, Kokkalis Z, Nakou M, et al. Anatomy and clinical implications of the ultrasound guided subsartorial saphenous nerve block. Reg Anesth Pain Med. 2011;36:399-402.

Manickam B, Perlas A, Duggan E, Brull R, Chan VW, Ramlogan R. Feasibility and efficacy of ultrasound-guided block of the saphenous nerve in the adductor canal. Reg Anesth Pain Med. 2009;34:578-80.

Tsai PB, Karnwal A, Kakazu C, Tokhner V, Julka IS. Efficacy of an ultrasound-guided subsartorial approach to saphenous nerve block: A case series. Can J Anaesth. 2010;57:683-8.

Van der Wal M, Lang SA, Yip RW. Transartorial approach for saphenous nerve block. Can J Anaesth. 1993;40:542-6.

Benzon HT, Sharma S, Calimaran A. Comparison of the different approaches to saphenous nerve block. Anesthesiology. 2005;102:633-8.

Lundblad M, Kapral S, Marhofer P, Lo ¨nnqvist PA. Ultrasound-guided infrapatellar nerve block in human volunteers: Description of a novel technique. Br J Anaesth. 2006;97:710-4.

Lund J, Jenstrup MT, Jaeger P, Sorensen AM, Dahl JB. Continuous adductor-canal-blockade for adjuvant post-operative analgesia after major knee surgery: Preliminary results. Acta Anaesthesiol Scand. 2011;55:14-9.

Comfort VK, Lang SA, Yip RW. Saphenous nerve anaesthesia-a nerve stimulator technique. Can J Anaesth. 1996;43:852-7.

De Tran QH, Clemente A, Finlayson RJ. A review of approaches and techniques for lower extremity nerve blocks. Can J Anaesth. 2007;54:922-34.

De Mey JC, Deruyck LJ, Cammu G, de Baerdemaeker LE, Mortier EP. A paravenous approach for the saphenous nerve block. Reg Anesth Pain Med. 2001;26:504-6.

Van der Wal M, Lang SA, Yip RW. Transsartorial approach for saphenous nerve block. Can J Anaesth. 1993;40: 542-6.

Arcila MA, Rivera RC, Campuzano D, Mejía MA, Martínez SM. Eficacia y seguridad del bloqueo de nervio supraescapular guiado por ultrasonido en pacientes con dolor crónico de hombro. Rev Colomb Anestesiol. 2013;41:104-8.

How to Cite
1.
Arcila Lotero MA, Rivera Díaz R, Mejía Aguilar MA, Jaramillo Jaramillo S. Efficacy and safety of ultrasound-guided saphenous nerve block in patients with chronic knee pain. Colomb. J. Anesthesiol. [Internet]. 2014 Jul. 1 [cited 2024 Jun. 17];42(3):166-71. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/647

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Published
2014-07-01
How to Cite
1.
Arcila Lotero MA, Rivera Díaz R, Mejía Aguilar MA, Jaramillo Jaramillo S. Efficacy and safety of ultrasound-guided saphenous nerve block in patients with chronic knee pain. Colomb. J. Anesthesiol. [Internet]. 2014 Jul. 1 [cited 2024 Jun. 17];42(3):166-71. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/647
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