Ultrasound-Guided Obturator Nerve Block: A Preliminary Report of a Case Series

Helayel, Pablo Escovedo; Conceição, Diogo Brüggemann da; Pavei, Patrícia; Knaesel, Julian Alexander; Filho, Getúlio Rodrigues de Oliveira

doi:10.1016/j.rapm.2007.01.006

Cited by 41 publications

(41 citation statements)

References 19 publications

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“…Recently, ultrasound-guided obturator nerve block has been identified [1][2][3][4]. Theoretically, the common obturator nerve should be visualized and blocked in close proximity to the exit of the obturator canal to increase the chance of success.…”

Section: Introductionmentioning

confidence: 99%

Ultrasound guided obturator nerve block: a single interfascial injection technique

et al. 2011

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We describe a new technique of single interfascial injection for 25 patients scheduled for transurethral bladder tumor resection. An ultrasound probe was placed at the midline of inguinal crease and moved medially and caudally to visualize the fascial space between the adductor longus (or pectineus) and adductor brevis muscles. We injected 20 mL 1% lidocaine containing epinephrine into the interfascial space using a transverse plane approach to make an interfascial injection, not an intramuscular swelling pattern. And just distally, firm pressure was applied for 3 min. Afterwards, surgery was performed under spinal anesthesia. The time required for identification and location of the nerve was 20 ± 15 and 30 ± 15 s, respectively. Adductor muscle strength, which was measured with a sphygmomanometer, decreased in all patients, from 122 ± 26 mmHg before blockade to 63 ± 11 mmHg 5 min after blockade. No movement or palpable muscle twitching occurred in 23 cases, slight movement of the thigh not interfering with the surgical procedure was observed in 1 case, thus the obturator reflex was successfully inhibited in 96% of cases. Ultrasound-guided single interfascial injection is an easy and successful technique for obturator nerve block.

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Section: Introductionmentioning

confidence: 99%

Ultrasound guided obturator nerve block: a single interfascial injection technique

et al. 2011

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“…We assessed success of obturator nerve block by measuring adductor muscle strength with a sphygmomanometer [17][18][19]. Patients were instructed to extend both knees fully, dorsiflex both ankles in the supine position and squeeze a blood pressure cuff inflated to 40 mmHg between their knees by adducting their hips while an investigator held down the contralateral knee to fixate it.…”

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confidence: 99%

A new ultrasound-guided pubic approach for proximal obturator nerve block: clinical study and cadaver evaluation

et al. 2015

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SummaryWe evaluated an alternative technique for ultrasound-guided proximal level obturator nerve block that might facilitate needle visualisation using in-plane ultrasound guidance. Twenty patients undergoing transurethral bladder tumour resection requiring an obturator nerve block were enrolled into a prospective observational study. With the patient in the lithotomy position, the transducer was placed on the medial thigh along the extended line of the inguinal crease, and aimed cephalad to view a thick fascia between the pectineus and obturator externus muscles that contains the obturator nerve. A stimulating nerve block needle was inserted at the pubic region and advanced inplane with the transducer in an anterior-to-posterior direction. Eight ml levobupivacaine 0.75% was injected within the fascia. The median (IQR [range]) duration for ultrasound identification of the target and injection were 8.5 (7-12 [5-24]) s and 62 (44.5-78.25 [39-383]) s, respectively. All blocks were successful. A cadaver evaluation demonstrated that the dye injected into the target fascia using our technique travelled retrogradely through the obturator canal, and surrounded the anterior and posterior branches of the obturator nerve both proximally and distally to the obturator canal. We believe that this is a promising new technique for ultrasound-guided proximal level obturator nerve block.

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“…Helayel et al (12), in Brazil among 22 subjects, demonstrated that ultrasound-guided obturator-nerve identification and block are technically easy and highly successful. The study by Abrahams and colleagues (13) in the United States revealed that blocks by ultrasonography guidance were more likely to be successful, took less time to perform, had faster onset, and had longer duration which is in congruence with our study.…”

Section: Discussionmentioning

confidence: 99%

Complications in Transurethral Resection of the Bladder Tumor: Using Nerve Stimulator with or Without Ultrasonography for Obturator Nerve Block: A Comparative Study

et al. 2017

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Background: The use of ultrasonographic guide is a suggested way to ease the obturator nerve block procedure. Accordingly, in this study, the procedures by selective obturator nerve block with and without use of ultrasonographic guide were compared. Methods: This interventional study was performed as an open-label randomized clinical trial among 50 consecutive subjects under surgery for intramural tumors of urinary bladder in a training hospital in 2016. The subjects were randomly assigned to be operated under spinal anesthesia accompanied with selective obturator nerve block (10 mL of 1.5% lidocaine adding 1:200000 epinephrine) with or without ultrasonographic guide. The outcomes were compared across the groups.

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Ultrasound-Guided Obturator Nerve Block: A Preliminary Report of a Case Series

Abstract: These preliminary data suggest that ultrasound-guided obturator-nerve identification and block are technically easy and highly successful.

Cited by 41 publications

References 19 publications

Ultrasound guided obturator nerve block: a single interfascial injection technique

Ultrasound guided obturator nerve block: a single interfascial injection technique

A new ultrasound-guided pubic approach for proximal obturator nerve block: clinical study and cadaver evaluation

Complications in Transurethral Resection of the Bladder Tumor: Using Nerve Stimulator with or Without Ultrasonography for Obturator Nerve Block: A Comparative Study

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