B90 Inter-fascial space between sartorius muscle and femoral artery – ISAFE: novel approach for adductor canal catheter – ACC
Bibliographic record
Abstract
Background and Aims We propose the ISAFE technique for ACC placement ( Figures - 1 & 2 ) to avoid the proximity of catheter tip to Femoral Vein-FV, an accidental venous-puncture, reduce potential trauma to saphenous nerve - SN, and prevent ACC - dislodgement. Methods ACC were inserted in sixteen total knee arthroplasty (TKA) patients postoperatively to avoid ACC displacement by the intraoperative thigh-tourniquet. 5 mL/h disposable elastomeric infusion-pump (Baxter-International-Inc.,IL,US) of 250 ml- Ropivacaine 0.2% infused over 48 hours-outpatient setting. The ISAFE approach: Needle insertion: level of the mid-adductor canal, mid-sartorius, in-plane (lateral to medial) Needle advancement: piercing through the posterior fascia of Sartorius muscle-SM approximately 1–2 cm lateral to Femoral Artery-FA, entering adductor canal (Figure 1). ISAFE hydro-dissection: Needle angle is then decreased to avoid FV and advanced into the inter-fascial space between FA and SM (Figure 1). Hydro-dissection is necessary to open the inter-fascial space and separating FA from SM. Catheter insertionat the 11 o’clock position anteromedial position to FA, facilitating over-threading catheter (Figure-2). We recommend threading the catheter approximately 3–5 mm past FA. Results No local-anesthetic systemic toxicity, intravascular puncture, or ACC-dislodgments was noted. 9-patients (56.25%) required NO opioid analgesia over three-day postoperative period. Mean cumulative opioid-consumption (in oral morphine-equivalent) on postoperative days- 2–3 were 10.78 ± 14.33 mg and 12.50 ± 18.68 mg, respectively. Conclusions The ISAFE approach for ACC placement is potentially safer, feasible, and reliable for maintaining analgesia after TKA. The ISAFE technique, while feasible for practitioners in regional anesthesia, has a learning-curve and requires training.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".