From the *Elective Surgery Centre, Silkeborg Regional Hospital, Silkeborg, Denmark; †Division of Clinical and Functional Anatomy, Medical University of Innsbruck, Innsbruck, Austria; and ‡Department of Anesthesiology and Intensive Care Medicine, Zealand University Hospital, University of Copenhagen, Copenhagen; and §Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark.
Reg Anesth Pain Med. 2017 Nov/Dec;42(6):725-730. doi: 10.1097/AAP.0000000000000675.
The popliteal nerve plexus contributes to afferent knee-pain conduction. It is mainly formed by genicular branches from the posterior obturator and the tibial nerves, innervating the intra-articular and posterior knee region. A subinguinal obturator nerve block alleviates pain after total knee arthroplasty. Reduced hip adductor motor function could be avoided by a posterior obturator nerve block inside the popliteal fossa.The aim of this study was to evaluate the spread of dye after a distal adductor canal (AC) injection to the popliteal fossa and coloring of the popliteal plexus and the genicular branch of the posterior obturator nerve by dissection. We also assessed the spread of dye into the popliteal fossa after a distal femoral triangle injection.
Ten milliliters of dye was injected into the distal part of the AC in 10 cadaver sides and into the distal part of the femoral triangle in 3 sides. Dissection was used to assess the spread of the injectate and coloring of the popliteal plexus and the genicular branch of the posterior obturator nerve, as well as the saphenous and medial vastus nerves.
The popliteal plexus and the genicular branch of the posterior obturator nerve were dyed in all 10 dissections after AC injections. No dye spread into the popliteal fossa after femoral triangle injections.
Injection of 10 mL of dye into the distal part of the AC spreads into the popliteal fossa and colors the popliteal plexus and the genicular branch of the posterior obturator nerve.
腘窝神经丛有助于传入膝关节疼痛的传导。它主要由发自后闭孔神经和胫神经的关节支组成，支配关节内和膝关节后部。隐神经沟内闭孔神经阻滞可缓解全膝关节置换术后疼痛。在腘窝内进行后闭孔神经阻滞可避免髋关节内收肌运动功能减弱。本研究旨在评估在 10 具尸体侧的股管（AC）远端注射 10ml 染料后向腘窝的扩散情况，以及通过解剖评估染料对胭窝丛和后闭孔神经关节支的染色情况。我们还评估了在股骨三角区远端注射后染料向胭窝的扩散情况。
在 10 具尸体侧的 AC 远端部分和 3 具尸体侧的股骨三角区远端部分注射 10ml 染料。通过解剖评估注射剂的扩散情况以及胭窝丛和后闭孔神经关节支、隐神经和股内侧肌的染色情况。
在所有 10 例 AC 注射后的解剖中，胭窝丛和后闭孔神经关节支均被染色。在股骨三角区注射后，没有染料扩散到胭窝。
在 AC 的远端部分注射 10ml 染料可扩散到胭窝并染色胭窝丛和后闭孔神经关节支。
