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Çiçek F, Koç T, Olgunus ZK. Connection between medial dorsal cutaneous nerve and saphenous nerve: case report. Surg Radiol Anat 2023; 45:1233-1237. [PMID: 37528298 DOI: 10.1007/s00276-023-03214-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/19/2023] [Indexed: 08/03/2023]
Abstract
PURPOSE There are no data on the connection of the saphenous nerve (SN), located on the medial side of the foot, with the terminal branches of the superficial fibular nerve. The aim of this study is to reveal the variation that surgeons should pay attention to for anesthesia applied in foot surgeries. METHODS In this study, the left foot of a 70-year-old female cadaver fixed with formalin was dissected. The distance to the medial malleolus and the incision line was recorded using digital caliper to determine the reference points in the resulting variation. RESULTS It was observed that a branch from the SN, which arose from the SN and proceeded anteriorly to the upper part of the medial malleolus and continued towards the dorsum of the foot, hooked with a branch from the medial dorsal cutaneous nerve (MDCN). The branches arising from this hook were distributed on the medial edge of the foot up to the proximal metatarsophalangeal joint I. The distance of this nerve connection to the medial malleolus is 91.14 mm, and the distance to the incision line is 15.76 mm. CONCLUSIONS It is suggested that the case presented as an unusual SN variation, which may affect the success of local anesthesia in invasive procedures to the medial part of the foot and could be considered in the evaluation of sensory loss after anteromedial surgical approach to the ankle, should be included in the classification of the cutaneous innervation pattern of the foot.
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Affiliation(s)
- Fatih Çiçek
- Department of Anatomy, School of Medicine, Niğde Ömer Halisdemir University, Niğde, Türkiye.
| | - Turan Koç
- Department of Anatomy, School of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Türkiye
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Faiz SHR, Imani F, Rahimzadeh P, Alebouyeh MR, Entezary SR, Shafeinia A. Which Ultrasound-Guided Sciatic Nerve Block Strategy Works Faster? Prebifurcation or Separate Tibial-Peroneal Nerve Block? A Randomized Clinical Trial. Anesth Pain Med 2018; 7:e57804. [PMID: 29637044 PMCID: PMC5881004 DOI: 10.5812/aapm.57804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 05/01/2017] [Accepted: 06/10/2017] [Indexed: 11/25/2022] Open
Abstract
Background Peripheral nerve block is an accepted method in lower limb surgeries regarding its convenience and good tolerance by the patients. Quick performance and fast sensory and motor block are highly demanded in this method. The aim of the present study was to compare 2 different methods of sciatic and tibial-peroneal nerve block in lower limb surgeries in terms of block onset. Methods In this clinical trial, 52 candidates for elective lower limb surgery were randomly divided into 2 groups: sciatic nerve block before bifurcation (SG; n = 27) and separate tibial-peroneal nerve block (TPG; n = 25) under ultrasound plus nerve stimulator guidance. The mean duration of block performance, as well as complete sensory and motor block, was recorded and compared between the groups. Results The mean duration of complete sensory block in the SG and TPG groups was 35.4 ± 4.1 and 24.9 ± 4.2 minutes, respectively, which was significantly lower in the TPG group (P = 0.001). The mean duration of complete motor block in the SG and TPG groups was 63.3 ± 4.4 and 48.4 ± 4.6 minutes, respectively, which was significantly lower in the TPG group (P = 0.001). No nerve injuries, paresthesia, or other possible side effects were reported in patients. Conclusions According to the present study, it seems that TPG shows a faster sensory and motor block than SG.
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Affiliation(s)
- Seyed Hamid Reza Faiz
- Associate Prof of Anesthesiology, Endometriosis and Gynecologic Disorders Research Center, Iran University of Medical Sciences, Iran
| | - Farnad Imani
- Prof of Anesthesiology, Pain Research Center, Iran University of Medical Sciences, Iran
| | - Poupak Rahimzadeh
- Associate Prof of Anesthesiology, Pain Research Center, Iran University of Medical Sciences, Iran
- Corresponding author: Poupak Rahimzadeh, Pain Research Center, Tehran, Iran. Tel: +98-9121064483, Fax: +98-2166509059, E-mail:
| | | | | | - Amineh Shafeinia
- Resident of Anesthesiology, Iran University of Medical Sciences, Iran
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Vadivelu N, Kai AM, Maslin B, Kodumudi V, Antony S, Blume P. Role of regional anesthesia in foot and ankle surgery. Foot Ankle Spec 2015; 8:212-9. [PMID: 25655517 DOI: 10.1177/1938640015569769] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
UNLABELLED Regional anesthesia has increasingly expanded its role in the perioperative care of patients undergoing foot and ankle surgery. In addition to avoiding side effects associated with both general anesthesia and neuraxial anesthetic techniques, especially those related to cardiovascular and pulmonary systems, regional nerve blocks have been shown to improve postoperative pain and reduce hospital stay and associated expenses. The techniques utilized to achieve analgesia of the foot and ankle are diverse, multifaceted, and often incorporate ultrasound guidance. Given the aging of patient populations, and especially the growing incidence of cardiovascular-, pulmonary-, and obesity-related morbidity, the use of regional blocks is likely to expand in these surgical procedures. This review highlights some of the most current developments in the expanding role of regional anesthesia in foot and ankle surgery. LEVELS OF EVIDENCE Therapeutic, Level II.
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Affiliation(s)
- Nalini Vadivelu
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (NV, BM, SA)Stony Brook University School of Medicine, Stony Brook, New York (AMK)College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut (VK)Yale-New Haven Hospital, New Haven, Connecticut (PB)
| | - Alice M Kai
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (NV, BM, SA)Stony Brook University School of Medicine, Stony Brook, New York (AMK)College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut (VK)Yale-New Haven Hospital, New Haven, Connecticut (PB)
| | - Benjamin Maslin
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (NV, BM, SA)Stony Brook University School of Medicine, Stony Brook, New York (AMK)College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut (VK)Yale-New Haven Hospital, New Haven, Connecticut (PB)
| | - Vijay Kodumudi
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (NV, BM, SA)Stony Brook University School of Medicine, Stony Brook, New York (AMK)College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut (VK)Yale-New Haven Hospital, New Haven, Connecticut (PB)
| | - Sible Antony
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (NV, BM, SA)Stony Brook University School of Medicine, Stony Brook, New York (AMK)College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut (VK)Yale-New Haven Hospital, New Haven, Connecticut (PB)
| | - Peter Blume
- Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut (NV, BM, SA)Stony Brook University School of Medicine, Stony Brook, New York (AMK)College of Liberal Arts and Sciences, University of Connecticut, Storrs, Connecticut (VK)Yale-New Haven Hospital, New Haven, Connecticut (PB)
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