Subsartorial (Adductor Canal Block)                                                                        

Dr Sanjay Desai

Content

Indications

Anatomy

Technique

Volume of LA

Specific Complications

References

 

Indications

The subsartorial block is a largely motor sparing block, anaesthetising the femoral nerve after most of the motor branches to quadriceps have already exited, providing anaesthesia and analgesia intraoperatively and postoperatively for:

Surgery to the anterior part of the knee e.g. Knee arthroscopy, Patellar surgery, ACL, MCL Reconstruction, Superficial surgery to the medial side of the leg.

In conjunction with a popliteal block for all surgery below the site of insertion on the lower limb.

Anatomy

The femoral nerve passes through the femoral canal to lie beneath the sartorius muscle, entering an aponeurotic intermuscular tunnel in the middle third of the medial side of the thigh called the Subsartorial canal, Adductor canal or Hunter’s canal.

The Adductor canal is bounded anterolaterally by vastus medialis, anteromedially by sartorius and posteriorly by adductor magnus.

The Adductor canal contains the femoral artery, femoral vein, saphenous nerve, nerve to vastus medialis and the posterior branch of the obturator nerve (see Image 1).

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