Name:
ACA- Hadzic- Peripheral Nerve Block 3e- Ultrasound-Guided Femoral Triangle Block
Description:
ACA- Hadzic- Peripheral Nerve Block 3e- Ultrasound-Guided Femoral Triangle Block
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/1cd115b5-4b0d-4fb2-b7f5-2c1d97842dd6/thumbnails/1cd115b5-4b0d-4fb2-b7f5-2c1d97842dd6.jpg?sv=2019-02-02&sr=c&sig=Y4UlZnBcFovWGiKMpPFs0d5rdHHZtVkMDZMFQVOUYug%3D&st=2023-03-23T23%3A34%3A45Z&se=2023-03-24T03%3A39%3A45Z&sp=r
Duration:
T00H03M39S
Embed URL:
https://stream.cadmore.media/player/1cd115b5-4b0d-4fb2-b7f5-2c1d97842dd6
Content URL:
https://asa1cadmoremedia.blob.core.windows.net/asset-685828bb-8f87-4735-a4ae-eb3291158ecf/ACA- Hadzic- Peripheral Nerve Block 3e- Ultrasound-Guided Fe.mov
Upload Date:
2022-02-23T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
DIGITAL INTRO TUNE:
DR. HADZIC: So we're going to do now a femoral triangle block in a patient who is having a total knee replacement surgery. So let's examine the anatomy. The transducer is placed on the medial aspect of the leg, and our initial goal is to visualize the femoral artery and the femoral vessels that surround it. On top of the femoral artery, what we see is the sartorius muscle and underneath we see two femoral veins.
DR. HADZIC: So let's now define the borders between the femoral triangle and the adductor canal. As we move the transducer more posteriorly and proximally, what we see here is the sartorius muscle and the adductor longus muscle form a certain triangle. At that point where they form a triangle, it's the limit of the adductor canal. it's the limit of the adductor canal. As we go more proximal, we can see how the adductor longus muscle becomes bigger.
DR. HADZIC: And then, as we trace more proximally, we can see the femoral artery and the femoral vessels and the saphenous nerve anterior to it in the femoral triangle. So this, here, would be posterior, this, here on the screen, would be anterior. And again, this is the sartorius muscle, femoral artery and the femoral vein and that is the saphenous nerve in the femoral triangle.
DR. HADZIC: Insertion of the needle here is in-plane. And here we can see how the needle approaches the femoral triangle, it goes through the sartorius muscle, now we are about to breach the posterior fascia of the sartorius muscle. We could actually see a distinct pop as the needle entered the femoral triangle. Twitch is absent, aspiration is negative and injection is with no high opening pressure.
DR. HADZIC: Here we can see the local anesthetic, how it disperses in the femoral triangle. It actually pushes the saphenous nerve away by the local anesthetic that has been injected into the triangle. The local anesthetic, of course, tracks proximally, which we can determine now by tracking more proximally, you can see how far the local anesthetic in the triangle reaches up and bathes the-- whatever remains of the femoral nerve in this case, mostly, it's the saphenous nerve, but we also see a branch to the vastus medialis muscle over here as well.
DR. HADZIC: As we go a bit more distally, again, we follow the femoral triangle and a massive spread of the local anesthetic with anesthetic that anesthetizes everything that is in it, and here we can see only the saphenous nerve primarily. And again, even if you're stuck there even if this is far distance, local anesthetic will spread. So, we're going to use 10 mLs of local anesthetic when the spread is adequate.
DR. HADZIC: That comprises the femoral triangle block.
DIGITAL OUTRO TUNE:
