Saphenous Nerve Block
Regional Anesthesia and Chronic Pain Applications
Branch of the femoral nerve
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- Follows the path of the greater saphenous vein
and is almost unique for a nerve its size by being purely sensory in its nature. (the other such nerve group is the superficial cervical plexus)
- Start above the knee joint on the antero-medial aspect of the lower thigh, transverse to the long axis of the leg. Use plenty of ultrasound gel and move the probe up and down the leg, and in a circumferential orientation looking for the greater saphenous vein.
Indications
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The saphenous nerve block is indicated in various surgical and nonsurgical treatments, it is most frequently utilized in conjunction with a popliteal sciatic nerve block to provide total anesthesia of the lower leg.
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The removal of foreign bodies, abscess drainage, ankle fracture or dislocation reduction, wound exploration, saphenous vein stripping, and ankle vein harvesting are a few of these.
Saphenous Nerve
- Follows the path of the greater saphenous vein and is almost unique for a nerve its size by being purely sensory in its nature. (the other such nerve group is the superficial cervical plexus)
- Start above the knee joint on the antero-medial aspect of the lower thigh, transverse to the long axis of the leg.
- Move the probe up and down the leg, and in a circumferential orientation looking for the greater saphenous vein.
Saphenous Nerve Block
- From the distal femoral nerve as it finishes it’s branch distribution down the anterior thigh
- Emerging from beneath the sartorius muscle in the medial distal upper leg and continues subcutaneously past the knee joint
- Giving off the infra-patellar branch and then continues distally splitting off the Medial Cutaneous Nerves of the leg
Saphenous Nerve
- Fairly shallow, above the muscle aponeurotic layer
- Depth to the saphenous vein depends on the patient’s habitus. Patients with little SubQ fat will likely have the saphenous vein in the top 2 cms of depth.
- Scanning patients with large amounts of subQ should probably begin at a depth of 4 cms to find the depth to the muscle fascia
References
and Interesting Articles
- Arnold C, Alvarado AC, Brady MF. Saphenous Nerve Block. [Updated 2022 May 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK536967/
- Chisholm MF, Bang H, Maalouf DB, Marcello D, Lotano MA, Marx RG, Liguori GA, Zayas VM, Gordon MA, Jacobs J, YaDeau JT. Postoperative Analgesia with Saphenous Block Appears Equivalent to Femoral Nerve Block in ACL Reconstruction. HSS J. 2014 Oct;10(3):245-51. doi: 10.1007/s11420-014-9392-x. Epub 2014 Jun 7. PMID: 25264441; PMCID: PMC4171445.
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