Anterior iliac block for bone graft harvesting: A cadaveric study

Hadi Ufuk Yörükoğlu; Abdullah Örs; Serdar Demiröz; Volkan Alparslan; Sevim Cesur; Özgür Çakır; Can Aksu

Makale detayları

Anterior iliac block for bone graft harvesting: A cadaveric study

Yazarlar:

Hadi Ufuk Yörükoğlu | Abdullah Örs | Serdar Demiröz | Volkan Alparslan | Sevim Cesur | Özgür Çakır | Can Aksu

Yayıncı:

Kocaeli University

Ana Başlıklar:

Anesteziyoloji

Dergi:

Acta Medica Nicomedia Vol.8 Issue 2, pp.197-201

Belge Tipi:

Makale

Yayın Tarihi:

6/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001353782

pISSN:

2717-8994

Anahtar kelimeler:

Özet:

 Objective: Anterior iliac crest AIC is frequently used as a donor site for various constructive surgeries. However, it is associated with severe postoperative pain that increases morbidity. To provide analgesia in the donor site with a low volume, a novel technique was described named anterior iliac block AIB. It provides effective analgesia, but the mechanism of action is not clear. We designed this study to demonstrate the mechanism of AIB. Methods: In this cadaveric study, AIB was performed with 10 mL right side and 20 mL left side of drug containing methylene blue and radiopaque dye on opposite sides. Following the block application, the spread on both sides was evaluated with 3D computed tomography. Afterwards, systematic layer-by-layer cadaver dissection was carried out by an orthopedic surgeon and anatomist experienced in pelvic anatomy. Results: The spread was more extensive on the left side, it predominantly extended in a cranial direction. In contrast, on the right side, where a lower volume was administered, the injectate remained localized within the fascial plane surrounding the iliac crest. On the left side, spread was observed in the fascial plane above the iliacus muscle, and the cutaneous branches of spinal nerves were stained. Additionally, dye was observed in the ilioinguinal nerve. On the right side, dye staining in the cutaneous branches above the iliac crest was observed. Conclusion: This cadaveric study demonstrates that AIB effectively targets the cutaneous branches of the subcostal, iliohypogastric, and ilioinguinal nerves with low volume.

 Objective: Anterior iliac crest AIC is frequently used as a donor site for various constructive surgeries. However, it is associated with severe postoperative pain that increases morbidity. To provide analgesia in the donor site with a low volume, a novel technique was described named anterior iliac block AIB. It provides effective analgesia, but the mechanism of action is not clear. We designed this study to demonstrate the mechanism of AIB. Methods: In this cadaveric study, AIB was performed with 10 mL right side and 20 mL left side of drug containing methylene blue and radiopaque dye on opposite sides. Following the block application, the spread on both sides was evaluated with 3D computed tomography. Afterwards, systematic layer-by-layer cadaver dissection was carried out by an orthopedic surgeon and anatomist experienced in pelvic anatomy. Results: The spread was more extensive on the left side, it predominantly extended in a cranial direction. In contrast, on the right side, where a lower volume was administered, the injectate remained localized within the fascial plane surrounding the iliac crest. On the left side, spread was observed in the fascial plane above the iliacus muscle, and the cutaneous branches of spinal nerves were stained. Additionally, dye was observed in the ilioinguinal nerve. On the right side, dye staining in the cutaneous branches above the iliac crest was observed. Conclusion: This cadaveric study demonstrates that AIB effectively targets the cutaneous branches of the subcostal, iliohypogastric, and ilioinguinal nerves with low volume.

 Objective: Anterior iliac crest AIC is frequently used as a donor site for various constructive surgeries. However, it is associated with severe postoperative pain that increases morbidity. To provide analgesia in the donor site with a low volume, a novel technique was described named anterior iliac block AIB. It provides effective analgesia, but the mechanism of action is not clear. We designed this study to demonstrate the mechanism of AIB. Methods: In this cadaveric study, AIB was performed with 10 mL right side and 20 mL left side of drug containing methylene blue and radiopaque dye on opposite sides. Following the block application, the spread on both sides was evaluated with 3D computed tomography. Afterwards, systematic layer-by-layer cadaver dissection was carried out by an orthopedic surgeon and anatomist experienced in pelvic anatomy. Results: The spread was more extensive on the left side, it predominantly extended in a cranial direction. In contrast, on the right side, where a lower volume was administered, the injectate remained localized within the fascial plane surrounding the iliac crest. On the left side, spread was observed in the fascial plane above the iliacus muscle, and the cutaneous branches of spinal nerves were stained. Additionally, dye was observed in the ilioinguinal nerve. On the right side, dye staining in the cutaneous branches above the iliac crest was observed. Conclusion: This cadaveric study demonstrates that AIB effectively targets the cutaneous branches of the subcostal, iliohypogastric, and ilioinguinal nerves with low volume.

 Amaç: Anterior iliak krest AİK, rekonstrüktif cerrahilerde sıklıkla greft donör sahası olarak tercih edilmektedir. Ancak bu bölgeye yönelik girişimler, morbiditeyi artıran ciddi postoperatif ağrılarla ilişkilidir. Donör bölgesine düşük hacimde lokal anesik ile analjezi sağlamak amacıyla anterior iliak blok AİB adı verilen yeni bir teknik tanımlanmıştır. AİB etkili bir analjezi sağlasa da etki mekanizması açık değildir. Bu çalışmayı, AIBnin etki mekanizmasını araştırmayı amaçladık. Yöntem: Bu kadavra çalışmasında, AİB sol tarafa 20 mL ve sağ tarafa 10 mL olacak şekilde metilen mavisi ve radyoopak boya içeren ilaçla uygulandı. Blok uygulamasının ardından, her iki taraftaki yayılım üç boyutlu bilgisayarlı tomografi ile değerlendirildi. Daha sonra, pelvik anatomi konusunda deneyimli bir ortopedi cerrahı ve bir anatomist tarafından sistematik olarak katman katman kadavra diseksiyonu gerçekleştirildi. Bulgular: Sol tarafta yayılım daha genişti ve özellikle kraniyal yönde ilerleme gözlendi. Buna karşılık, daha düşük hacmin uygulandığı sağ tarafta, enjeksiyon sıvısı iliak krest çevresindeki fasyal plan içinde sınırlı kaldı. Sol tarafta, iliakus kası üzerindeki fasyal planda yayılım gözlendi ve spinal sinirlerin kutanöz dalları boyandı. Ayrıca, ilioinguinal sinirde de boya izlendi. Sağ tarafta ise iliak krest üzerindeki kutanöz dallarda boya tutulumu saptandı. Sonuç: Bu kadavra çalışması, AİBnin düşük hacimle uygulandığında subkostal, iliohipogastrik ve ilioinguinal sinirlerin kutanöz dallarını etkili bir şekilde hedef aldığını göstermektedir.

Makale detayları

Anterior iliac block for bone graft harvesting: A cadaveric study

Yazarlar:

Hadi Ufuk Yörükoğlu | Abdullah Örs | Serdar Demiröz | Volkan Alparslan | Sevim Cesur | Özgür Çakır | Can Aksu

Yayıncı:

Kocaeli University

Ana Başlıklar:

Anesteziyoloji

Dergi:

Acta Medica Nicomedia Vol.8 Issue 2, pp.197-201

Belge Tipi:

Makale

Yayın Tarihi:

6/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001353782

pISSN:

2717-8994

Regional anesthesia

anterior iliak block

cadaveric study

postoperative analgesiaRejyonal anestezi

anterior iliak blok

kadavra çalışması

postoperatif analjezi

Sayı

Makale detayları

Yazarlar: Hadi Ufuk Yörükoğlu | Abdullah Örs | Serdar Demiröz | Volkan Alparslan | Sevim Cesur | Özgür Çakır | Can Aksu

Yayıncı: Kocaeli University

Ana Başlıklar: Anesteziyoloji

Dergi: Acta Medica Nicomedia Vol.8 Issue 2, pp.197-201

Belge Tipi: Makale

Yayın Tarihi: 6/2025

Belge Dili: İngilizce

Document ID (Org No.): 2001353782

pISSN: 2717-8994

Sayı

Yazarlar:

Hadi Ufuk Yörükoğlu | Abdullah Örs | Serdar Demiröz | Volkan Alparslan | Sevim Cesur | Özgür Çakır | Can Aksu

Yayıncı:

Kocaeli University

Ana Başlıklar:

Anesteziyoloji

Dergi:

Acta Medica Nicomedia Vol.8 Issue 2, pp.197-201

Belge Tipi:

Makale

Yayın Tarihi:

6/2025

Belge Dili:

İngilizce

Document ID (Org No.):

2001353782

pISSN:

2717-8994