Kim Jiyoung, Kim Ji Yeong, Shin Hwa Yong, Sim Sung Eun, Chung Siwook, Jeon Youngjae, Kim Sang Hyun, Jeong Jong Min, Kim Jieun, Lee U-Young, Park Hue Jung
Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Korea.
Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Korea.
Korean J Pain. 2023 Jul 1;36(3):328-334. doi: 10.3344/kjp.23112. Epub 2023 Jun 22.
Among the four genicular nerves innervating the anterior aspect of the knee, the inferior lateral genicular nerve has been omitted as a target of blocking. Some authors have suggested that the inferior lateral genicular nerve of the knee might pass beneath the lateral collateral ligament of knee. The authors aimed to study the location of the inferior lateral genicular nerve and the spread of injectate during the inferior lateral genicular nerve block.
In ten knees from fresh frozen cadavers, the authors performed on each an ultrasound-guided block of the inferior lateral genicular nerve of the knee just below the lateral collateral ligament. The needle was inserted below the lateral collateral ligament, and 2 mL of blue dye was injected. A week later, the cadavers were dissected, and the existence of the inferior lateral genicular nerve and the spread of dye around it was investigated.
The proportion of inferior lateral genicular nerves branching from the common peroneal nerve was found in 8 of 10 (80.0%) cadavers. Of these eight cadavers with inferior lateral genicular nerve, five specimens (62.5%) were stained with blue dye. The common peroneal nerve was not infiltrated with dye in any specimens.
When 2 mL of dye was inserted inferiorly to the lateral collateral ligament, the inferior lateral genicular nerve could be blocked in 62.5% of specimens. Because the common peroneal nerve was not involved in any specimen, motor weakness would be avoided with this method.
在支配膝关节前侧的四条膝神经中，膝下外侧神经未被列为阻滞靶点。一些作者认为，膝下外侧神经可能从膝关节外侧副韧带下方穿过。作者旨在研究膝下外侧神经的位置以及膝下外侧神经阻滞时注射剂的扩散情况。
在10具新鲜冷冻尸体的膝关节上，作者在每具尸体的膝关节外侧副韧带下方进行超声引导下的膝下外侧神经阻滞。将针插入外侧副韧带下方，并注入2毫升蓝色染料。一周后，解剖尸体，研究膝下外侧神经的存在情况及其周围染料的扩散情况。
在10具尸体中的8具（80.0%）发现膝下外侧神经从腓总神经分支。在这8具存在膝下外侧神经的尸体中，有5个标本（62.5%）被蓝色染料染色。在任何标本中，腓总神经均未被染料浸润。
当在外侧副韧带下方注入2毫升染料时，62.5%的标本中膝下外侧神经可被阻滞。由于在任何标本中腓总神经均未受累，因此该方法可避免运动无力。
