Obturator nerve block

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Abstract


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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About the authors

V. A. Koriachkin

Saint-Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation

Email: dmitriigribanov76@gmail.com
ORCID iD: 0000-0002-3400-8989

Russian Federation, Saint-Petersburg

D. V. Zabolotskii

Saint-Petersburg State Pediatric Medical University of the Ministry of Healthcare of the Russian Federation

Email: dmitriigribanov76@gmail.com
ORCID iD: 0000-0002-6127-0798

Russian Federation, Saint-Petersburg

D. V. Gribanov

St Luka Clinical Hospital

Author for correspondence.
Email: dmitriigribanov76@gmail.com
ORCID iD: 0000-0001-7034-6419

Russian Federation, Saint Petersburg

заведующий отделением анестезиологии и реанимации

T. A . Antoshkova

St Luka Clinical Hospital

Email: dmitriigribanov76@gmail.com
ORCID iD: 0000-0002-9537-6523

Russian Federation, Saint Petersburg

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Supplementary files

Supplementary Files Action
1.
Fig. 1. Muscle innervation by the obturator nerve [24]

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2.
Fig. 2. The needle is withdrawn and redirected laterally and slightly inferiorly and advanced 1.5–2 cms beyond the previously noted depth [25]

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3.
Fig. 3. Transducer positions for performance of ultrasound-guided obturator nerve block technique

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4.
Fig. 4. Distal approach the obturator nerve block with visualization of anterior and posterior divisions of the obturator nerve [18]. AON – anterior division of obturator nerve. PON – posterior division of obturator nerve

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5.
Fig. 5. Transducer positions for performance of ultrasound-guided obturator nerve block technique

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6.
Fig. 6. Proximal approach to the obturator nerve block as described by Lin [18]. ON — obturator nerve

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7.
Fig. 7. Algorithm the blockade of the obturator nerve with ultrasound [34]

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