Anatomical considerations for obturator nerve block with fascia iliaca compartment block

2021 ◽  
pp. rapm-2021-102553
Author(s):  
Thomas Fichtner Bendtsen ◽  
Erik Morre Pedersen ◽  
Bernhard Moriggl ◽  
Peter Hebbard ◽  
Jason Ivanusic ◽  
...  

This report reviews the topographical and functional anatomy relevant for assessing whether or not the obturator nerve (ON) can be anesthetized using a fascia iliaca compartment (FIC) block. The ON does not cross the FIC. This means that the ON would only be blocked by an FIC block if the injectate spreads to the ON outside of the FIC. Such a phenomena would require the creation of one or more artificial passageways to the ON in the retro-psoas compartment or the retroperitoneal compartment by disrupting the normal anatomical integrity of the FI. Due to this requirement for an artificial pathway, an FIC block probably does not block the ON.

Medicina ◽  
2020 ◽  
Vol 56 (4) ◽  
pp. 150
Author(s):  
Seounghun Lee ◽  
Jung-Mo Hwang ◽  
Sangmin Lee ◽  
Hongsik Eom ◽  
Chahyun Oh ◽  
...  

Background and Objectives: The effect of supra-inguinal fascia iliaca compartment block (SI-FICB) in hip arthroscopy is not apparent. It is also controversial whether SI-FICB can block the obturator nerve, which may affect postoperative analgesia after hip arthroscopy. We compared analgesic effects before and after the implementation of obturator nerve block into SI-FICB for hip arthroscopy. Materials and Methods: We retrospectively reviewed medical records of 90 consecutive patients who underwent hip arthroscopy from January 2017 to August 2019. Since August 2018, the analgesic protocol was changed from SI-FICB to SI-FICB with obturator nerve block. According to the analgesic regimen, patients were categorized as group N (no blockade), group F (SI-FICB only), and group FO (SI-FICB with obturator nerve block). Primary outcome was the cumulative opioid consumption at 24 hours after surgery. Additionally, cumulative opioid consumption at 6 and 12 hours after surgery, pain score, additional analgesic requests, intraoperative opioid consumption and hemodynamic stability, and postoperative nausea and vomiting were assessed. Results: Among 87 patients, there were 47 patients in group N, 21 in group F, and 19 in group FO. The cumulative opioid (fentanyl) consumption at 24 hours after surgery was significantly lower in the group FO compared with the group N (N: 678.5 (444.0–890.0) µg; FO: 482.8 (305.8–635.0) µg; p = 0.014), whereas the group F did not show a significant difference (F: 636.0 (426.8–803.0) µg). Conclusion: Our findings suggest that implementing obturator nerve block into SI-FICB can reduce postoperative opioid consumption in hip arthroscopy.


Urology ◽  
1985 ◽  
Vol 26 (6) ◽  
pp. 588-589 ◽  
Author(s):  
Tsunetada Yazaki ◽  
Hiromichi Ishikawa ◽  
Shori Kanoh ◽  
Kenkichi Koiso

2008 ◽  
Vol 106 (1) ◽  
pp. 350-351 ◽  
Author(s):  
Yoshihiro Fujiwara ◽  
Yutaka Sato ◽  
Masato Kitayama ◽  
Yasuyuki Shibata ◽  
Toru Komatsu ◽  
...  

2011 ◽  
Vol 21 (3) ◽  
pp. 129-133
Author(s):  
Zeki Tuncel Tekgül ◽  
Rauf Taner Divrik ◽  
Murat Turan ◽  
Esen Şimşek ◽  
Ersin Konyalıoğlu ◽  
...  

2009 ◽  
Vol 16 (01) ◽  
pp. 48-52
Author(s):  
NASEEM AHMED ◽  
Shahid Mahmood Rana ◽  
SYED MUHAMMAD ZAHEER HAIDER ◽  
Arshad Mahmood ◽  
FAIZAN AHMED ◽  
...  

Objectives: To evaluate the efficacy of obturator nerve block combined with spinal anaesthesia for prevention of adductormuscle spasm and its associated complications during transurethral resection of bladder tumours located at its lateral and inferolateral wall.Study design: A prospective study. Setting: At AFIU Rawalpindi. Period: From January 2005 to December 2006. Material and methodFifty patients who had tumours at their lateral / inferolateral bladder wall of physical status ASA I - IV received spinal anaesthesia at 3r d or4l h lumbar space followed by obturator nerve block with a view to preventing adductor jerk during resection of tumour. Results: There wascomplete suppression of adductor jerk in 45 (90%) patients and surgery was completed smoothly. Two patients (4%) had mild adductorjerk and additional sedation was required. The block failed to work in 3 (6%) cases and required conversion to general anaesthesia. Thusthe procedure was successful in 94% (complete and partial suppression of jerk. Conclusion: We conclude that spinal anaesthesiacombined with obturator nerve block is an effective technique for preventing adductor jerk during TUR-BT, thus avoiding intra-operative andpost operative complication.


2021 ◽  
Vol 14 (3) ◽  
pp. 130-140
Author(s):  
V. A. Koriachkin ◽  
D. V. Zabolotskii ◽  
D. V. Gribanov ◽  
T. A . Antoshkova

One of the forgotten techniques of regional anesthesia is blockade of the obturator nerve, which was performed using anatomical landmarks and neurostimulation. In recent years, ultrasonic navigation methods have gained wide popularity when using regional blockades. The purpose of the review is to present the current understanding of the use of obturator nerve block in clinical practice. The review presents the anatomical features of the obturator nerve passage, surgical and therapeutic indications for the use of its blockade. The technique for performing obturator blockade using ultrasound navigation is described in detail. Blockade of the obturator nerve using ultrasound navigation can reduce the likelihood of surgical complications during transurethral resection of a tumor located on the lateral wall of the bladder, improve analgesia after hip and knee surgery, and effectively relieve spastic conditions of the adductor muscles of the hip.


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