In this “Blockjocks” video from the Andrews Institute, Dr. Brandon Winchester demonstrates a new ultrasound-guided adductor canal catheter technique for post-operative pain control. Dr. Winchester takes an oblique approach that stays as proximal as possible while still maintaining motor sparing.
Benefits of this oblique insertion include easier threading of the catheter down the canal, and a more cranial insertion point that’s further above the level of the tourniquet. In other words, this technique may allow the anesthesiologist to put the catheter in pre-operatively without interrupting the surgeon’s sterile field, and may reduce the likelihood of internal dislodgement of the catheter.
Interesting moments in this video include:
- (4:35) Dr. Winchester points out the sonoanatomy of the thigh aroudn the area of the needle insertion
- (6:00) Needle insertion and injection viewed on ultrasound
- (8:10) Threading the catheter down the canal
- (11:10) Applying the dressing over the catheter, away from the expected margin of the sterile field