A paravenous approach for the saphenous nerve block

Background and Objectives: This study assesses a paravenous approach for sa phenous nerve block at approximately the level of the tibial tuberosity, an d compares it with the conventional technique of blind subcutaneous infiltr ation between the tibial tuberosity and the gastrocnemius muscle. Methods: In dissections of 5 cadavers, the saphenous nerve was found very c lose to the saphenous vein bilaterally. Subsequently, in 20 volunteers, a b ilateral saphenous nerve block was performed with 5 mL mepivacaine on each side. Randomly assigned, the block was performed by blind subcutaneous inje ction using a 23-gauge needle of 2.5 cm on one side and by a paravenous sub cutaneous approach on the other. Results: The paravenous approach produced a saphenous nerve block in all 20 volunteers whereas the blind subcutaneous approach was successful in only 6 (33%) (P <.05). Seven volunteers had a painless minor hematoma at the par avenous site and 2 had a hematoma at the classical site. Conclusion: The saphenous nerve can be blocked effectively by a paravenous approach using only 5 mL of local anesthetic solution. This approach is adv antageous because of its easily identifiable landmark.