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Ultrasound‐Guided Posterior Femoral Cutaneous Nerve Block: A Cadaveric Study
Author(s) -
Johnson Christopher S.,
Johnson Rebecca L.,
Niesen Adam D.,
Stoike David E.,
Pawlina Wojciech
Publication year - 2018
Publication title -
journal of ultrasound in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.574
H-Index - 91
eISSN - 1550-9613
pISSN - 0278-4297
DOI - 10.1002/jum.14429
Subject(s) - medicine , cadaver , cadaveric spasm , thigh , anatomy , deep fascia , femoral nerve , nerve block , fascia , dissection (medical) , local anesthetic , sciatic nerve , neurolysis , surgery
Objectives To identify any anatomic barriers to local anesthetic spread between the sciatic nerve (SN) and the posterior femoral cutaneous nerve (PFCN) at the level of the infragluteal crease and to describe a potential technique for an ultrasound (US)‐guided subgluteal PFCN block in a cadaveric model. Methods Bilateral US‐guided subgluteal injections of a colored latex solution were performed around the SN (15 mL) and PFCN (10 mL) in 4 unembalmed cadavers, for a total of 8 cadaver thighs. The specimens were dissected after latex polymerization to observe the spread of the latex solutions. Results With US guidance, the PFCN was visualized deep to the gluteus maximus and slightly superficial or lateral to the SN at the level of the infragluteal crease. The SN and PFCN were found on dissection to be coated with their respective colored latex in all 8 thighs. The SN and PFCN were consistently separated by the deep investing muscular fascia of the thigh, with only 2 thighs showing substantial mixing of latex injectates. Conclusions The deep investing muscular fascia of the thigh appears to impede the spread of injectate between the SN and PFCN in a most unembalmed cadaver specimens. A US‐guided subgluteal PFCN blockade may be a feasible technique to complement an SN block when complete anesthesia of the posterior thigh is required.