Obturator Nerve Block: From Anatomy to Ultrasound Guidance

Anagnostopoulou, Sofia; Kostopanagiotou, Georgia; Paraskeuopoulos, Tilemachos; Alevizou, Anastasia; Saranteas, Theodosis

doi:10.1213/01.ane.0000297272.42192.70

Cited by 17 publications

(8 citation statements)

References 2 publications

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“…With respect to the technique, Soong et al. observed that imaging occurred best with the leg straight and just slight external rotation (22).…”

Section: Obturator Nerve Blockmentioning

confidence: 99%

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Ultrasound guided lower extremity blocks

Flack

Anderson

2011

Pediatric Anesthesia

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“…With respect to the technique, Soong et al. observed that imaging occurred best with the leg straight and just slight external rotation (22).…”

Section: Obturator Nerve Blockmentioning

confidence: 99%

“…The importance of the obturator nerve with regard to sensory innervation of the medial and posterior knee should not be underestimated (25,26). With respect to the technique, Soong et al observed that imaging occurred best with the leg straight and just slight external rotation (22).…”

Section: Commentsmentioning

confidence: 99%

Ultrasound guided lower extremity blocks

Flack

Anderson

2011

Pediatric Anesthesia

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“…Introducing the needle with an out-of-plane approach may result to a different distance compared to an in-plane approach. In a feasibility study of ultrasound guided obturator nerve block, Fujiwara et al [10] provided an image showing the skin to obturator nerve with a distance of less than 2 mm, which was criticized by Anagnostopoulou et al [16]. In a sonographic study by Soong et al [9] the common obturator nerve, the anterior division and the posterior division were found at 25.9 mm, 15.5 mm and 29.3 mm, respectively, distances not differing significantly from those reported by Manassero et al [15].…”

Section: Discussionmentioning

confidence: 99%

Peripheral nerve blockade as an exclusive approach to obturator nerve block in anterior cruciate ligament reconstructive surgery

Simeoforidou

Bareka

Βasdekis

et al. 2013

Korean J Anesthesiol

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BackgroundObturator nerve block plays an additive role on the quality of analgesia for knee surgery. Since the use of dual guidance increases the success rate of nerve blocks, we investigated the feasibility of performing anterior cruciate ligament reconstruction under dual-guided blockade of obturator with femoral and sciatic nerves. Furthermore, we propose a novel method for the assessment of obturator nerve block.MethodsFifty-seven patients undergoing anterior cruciate ligament repair were studied. Neurostimulating needles were guided out-of-plane by ultrasound. To induce the obturator nerve block, 10 ml of ropivacaine 0.5% were injected after eliciting contractions of adductor longus, brevis and magnus followed by block assessment for 30 minutes by examining the patient lift and left down the leg.ResultsThe sonographic recognition of obturator nerve was easy and quick in all cases. Time for applying the block was 119.9 ± 79.2 sec. Assessing this block with lifting-leaving down the leg gave satisfactory results in 24.0 ± 5.07 min. After performing femoral-sciatic blocks, the inflation of tourniquet resulted in VAS score of > 0 in 2/57 patients and operation in 12/57. Total dose of fentanyl was 120.1 ± 64.6 µg and of midazolam 1.86 ± 0.8 mg. In 6 patients propofol was administered for sedation and 1 of them required ventilation with laryngeal mask airway, converting the anesthesia technique to general anesthesia.ConclusionsOur data suggest that anterior cruciate ligament reconstruction can be performed under obturator-femoral-sciatic blocks. Identification of obturator nerve with ultrasound is easy and the block can be assessed by observing how the patient lifts and leaves down the leg.

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“…All the US-guided blocks were conducted using previously published techniques [32][33][34][35][36][37][38]. The success of the sensory and motor blockade was examined 30 min after completion of the block as described in our previous trial [4].…”

Section: Methodsmentioning

confidence: 99%

Perineural versus Intravenous Dexamethasone for Prolongation of Multiple Nerve Blocks for Pain Relief after Total Knee Arthroplasty

Stav¹,

Reytman²,

Stav³

et al. 2017

J Pain Relief

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Background: Multiple nerve blocks (MNB) provide excellent time-limited perioperative analgesia following total knee arthroplasty. Both perineural and systemic use of dexamethasone (DXM) as an adjuvant to local anesthetic prolong the duration of single-shot MNB. We hypothesized that preoperative perineural injection of DXM prolongs analgesia after MNB more than the same dose of intravenous (IV) DXM injection due to direct action on the nerves and not only by a systemic action mechanism.

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Obturator Nerve Block: From Anatomy to Ultrasound Guidance

Cited by 17 publications

References 2 publications

Ultrasound guided lower extremity blocks

Ultrasound guided lower extremity blocks

Peripheral nerve blockade as an exclusive approach to obturator nerve block in anterior cruciate ligament reconstructive surgery

Perineural versus Intravenous Dexamethasone for Prolongation of Multiple Nerve Blocks for Pain Relief after Total Knee Arthroplasty

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