Ultrasound-guided block of sciatic and femoral nerves: an anatomical study.
The sheep is a popular animal model for human biomechanical research involving invasive surgery on the hind limb. These painful procedures can only be ethically justified with the application of adequate analgesia protocols. Regional anaesthesia as an adjunct to general anaesthesia may markedly improve well-being of these experimental animals during the postoperative period due to a higher analgesic efficacy when compared with systemic drugs, and may therefore reduce stress and consequently the severity of such studies. As a first step 14 sheep cadavers were used to establish a new technique for the peripheral blockade of the sciatic and the femoral nerves under sonographic guidance and to evaluate the success rate by determination of the colorization of both nerves after an injection of 0.5 mL of a 0.1% methylene blue solution. First, both nerves were visualized sonographically. Then, methylene blue solution was injected and subsequently the length of colorization was measured by gross anatomical dissection of the target nerves. Twenty-four sciatic nerves were identified sonographically in 12 out of 13 cadavers. In one animal, the nerve could not be ascertained unequivocally and, consequently, nerve colorization failed. Twenty femoral nerves were located by ultrasound in 10 out of 13 cadavers. In three cadavers, signs of autolysis impeded the scan. This study provides a detailed anatomical description of the localization of the sciatic and the femoral nerves and presents an effective and safe yet simple and rapid technique for performing peripheral nerve blocks with a high success rate.
Orthopaedic Center for Musculoskeletal Research, Department of Orthopaedic Surgery, Koenig-Ludwig-Haus, Julius-Maximilians-University, Wuerzburg, Germany.
Sonja
S
Waag
Michael H
MH
Stoffel
Claudia
C
Spadavecchia
Urs
U
Eichenberger
Helene
H
Rohrbach
D000818:Animals; D002102:Cadaver; D004396:Coloring Agents; D005260:Female; D005267:Femoral Nerve / Q000000981:diagnostic imaging / Q000601:surgery*; D007279:Injections, Subcutaneous / Q000379:methods*; D008751:Methylene Blue; D009407:Nerve Block / Q000379:methods*; D012584:Sciatic Nerve / Q000000981:diagnostic imaging / Q000601:surgery*; D012756:Sheep; D018084:Ultrasonography, Interventional
D004396:Coloring Agents; D008751:Methylene Blue
anatomy; hind limb surgery; regional anaesthesia; sheep; ultrasound